Causes and early prognosis of non-traumatic coma in Tanzania. Muhimbili Medical Centre experience.

Abstract

150 patients admitted in medical coma at Muhimbili Medical Centre were studied prospectively to determine the causes and early prognosis. 89 (60%) patients had potentially treatable causes (60 cerebral malaria, 16 meningitis, 7 diabetic ketoacidosis and 6 drug over dosage). Other causes were 20 (13%) with cerebrovascular diseases, 30 (20%) hepatic failure and 11 (8%) were of miscellaneous and obscure causes. The cause of coma was an important indicator of prognosis. Good recovery was achieved in 42 (70%) with cerebral malaria, 4 (57%) diabetic ketoacidosis, 4 (25%) meningitis and 1 (16%) drug overdosage. Other indicators were the Glasgow Coma Score on admission and subsequent scores, early neurological signs and complications that arose. The Glasgow Coma Scale was found useful and easy to perform. Further studies are needed to confirm its usefulness in developing countries.