Principal Causes of Coma in Medical Units of A Tertiary Care Hospitals of Peshawar

To determine the principal causes of coma in patients admitted to the medical units of a tertiary care hospital of Peshawar.
This cross sectional study was conducted at department of medicine, Khyber teaching hospital Peshawar, from July 2006 to August 2007. All patients were randomly selected. Relevant information's were recorded on a questionnaire prepared in accordance with the objectives of the study.
A total of 124 patients with coma, 96(77.41%) males and 28(22.58%) females were included in the study. The age range of patients was from 12 years to 72 year with mean age of 50.5 years. The principal causes of coma were: cerebrovascular accident (CVA) 73.38% (n=91), epilepsy in 10.48% (n=13), injury head 5.64% (n=11), hepatic coma 2.41% (n=3), central nervous system (CNS) infections 2.41% (n=3), metabolic acidosis, drug abuse (1.61%) (n=2) each and cerebral malaria, hypoglycemia and uremia 0.8%(n=1) each. Risk factors for stroke recorded were hypertension in 46.2% (n=42/91), diabetes in 15.4% (n=14/91), ischemic heart disease 12.1% (n=11/91), smoking 5.5% (n=5/91), hyperlipedemia 3.3% (n=3/91) and atrial fibrillation 1.1% (n=1/91). Scoring on Glasgow coma scale showed that 74.2% (n=92) patients scored 3-8, 25.8% (n=32) scored 9-12 and none of the patients scored 13-15.
In our setup CVA is the most common cause of coma followed by epilepsy, and trauma head. Other minor causes recorded were metabolic acidosis, drug abuse, central nervous system infections, cerebral malaria, hypoglycemia and uremia.