ISMJ

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Approximately 3 to 5 % of referrals to emergency wards of big cities are involved in diseases causing loss of consciousness (LOC). Since many of these patients encounter death or disabilities, determining a systematic approach for early diagnosis and treatment has a high priority this will be achieved through revealing the etiologies responsible for LOC and hospital outcome in an emergency ward. A total of 392 patient older than 12 years old (54.8% male, 45.2% female, with a mean age of 49.9) presenting with LOC were enrolled in this cross-sectional study in emergency ward of Bushehr University Hospital. LOC was defined as a clinical state manifested by any decrease of consciousness ranging from confusion to deep coma. Etiology of LOC was metabolic in 42.9%, structural in 40.1% and infective in 6% of patients. It remained unknown in 11% despite extensive investigation. The most prevalent causes in subgroups were cerebrovascular accidents (30.6%), drug intoxication (22.35%) and hypoxic-anoxic conditions (11.7%), respectively. Mortality rate caused by infective, structural and metabolic etiologies had a frequency of 33.3%, 26.8% and 22% respectively. Structural etiologies had the most severe prognosis and caused neurological damages in 54.7% of patients. Metabolic etiologies with 3.8% had the lowest rate in neurological damages. In an overall view, metabolic causes were the most common etiology responsible for non- traumatic LOC.

Keywords: cComa, non-trauma, metabolic, cerebrovascular accidents, drug intoxication

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