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Introduction: Coma is a medical emergency, and optimal management, especially in a resource-poor setting, depends on knowledge of its aetiology and predictors of outcome. This study aimed to provide hospital-based data on the prevalence, etiology, and outcome of non traumatic coma (NTC) in adults at a tertiary level in Cameroon. Methods: A three year retrospective cohort study of medical records of patients aged 18 years and above, who presented in coma of non-traumatic origin at a Cameroon emergency department (ED) was conducted. Data related to sociodemographic, clinical findings, investigations, etiology of the coma, and outcomes were collected. Results: A total of 408 patients were recruited, 214 (52.5 %) were males. The mean age was 55.9 ± 16.6 years. NTC accounted for 2.2 % of all consultations at the ED during the period of study. Stroke (29.6 %), infections (19.8 %), and metabolic disorders (12.6 %) were the most frequent cause of NTC. Etiology was unknown in 23.3 % of our participants. The in-hospital mortality was 66.4 %. Duration of hospitalization ≤ 3 days, GCS ã 6, serum creatinine level ã 13 mg/L, and administration of adrenergic drugs were predictors of mortality. Overall survival rate was 44.3 % after 5 days of admission. Conclusion: Non-traumatic coma had various aetiologies. Stroke accounted for almost one third of cases. About three out of five patients died in hospital. Deep coma, high serum creatinine level, short hospital stay and administration of adrenergic medications were independent predictors of mortality.
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Introduction Coma is a medical emergency, and optimal management, especially in a resource-poor setting, depends on knowledge of its aetiology and predictors of outcome. This study aimed to provide hospital-based data on the prevalence, etiology, and outcome of non traumatic coma (NTC) in adults at a tertiary level in Cameroon. Methods A three year retrospective cohort study of medical records of patients aged 18 years and above, who presented in coma of non-traumatic origin at a Cameroon emergency department (ED) was conducted. Data related to sociodemographic, clinical findings, investigations, etiology of the coma, and outcomes were collected. Results A total of 408 patients were recruited, 214 (52.5 %) were males. The mean age was 55.9 ± 16.6 years. NTC accounted for 2.2 % of all consultations at the ED during the period of study. Stroke (29.6 %), infections (19.8 %), and metabolic disorders (12.6 %) were the most frequent cause of NTC. Etiology was unknown in 23.3 % of our participants. The in-hospital mortality was 66.4 %. Duration of hospitalization ≤ 3 days, GCS ã 6, serum creatinine level ã 13 mg/L, and administration of adrenergic drugs were predictors of mortality. Overall survival rate was 44.3 % after 5 days of admission. Conclusion Non-traumatic coma had various aetiologies. Stroke accounted for almost one third of cases. About three out of five patients died in hospital. Deep coma, high serum creatinine level, short hospital stay and administration of adrenergic medications were independent predictors of mortality.
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Humanos , Masculino , Femenino , Heridas y Lesiones , ComaRESUMEN
Few data on neuropsychiatric disorders in systemic lupus erythematosus (NPSLE) are available in sub-Saharan Africa. The purpose of this study was to determine their frequency and describe their features in Cameroon. We conducted a retrospective study collecting all the medical records of patients with systemic lupus erythematosus (SLE) hospitalized in the department of rheumatology of 3 hospitals in Cameroon from 2009 to 2019. Lupus activity was assessed using the SLE activity index (SLEDAI). A total of 108 records of patients with a mean age of 40.2 ± 13.7 years were included in the study. The frequency of NPSLE was 55.5% (n=60). Neuropsychiatric disorders were diagnosed concomitantly with SLE (37.0%; n = 40) while in 20 patients with SLE (18.5%) they occurred during the first year. When NPSLE were inaugural, central nervous system involvement was dominant, with demyelinating syndrome 27.8% (n=30) and headaches 21.3% (n=23). Mononeuropathy was the most frequent peripheral nervous system involvement (15.7%; n=17). Factors associated with NPSLE occurrence were malar rash (p=0.024), alopecia (p=0.024), very high lupus activity (p=0.011), arthralgia (p<0.001), anti-nuclear factor (p=0.002). NPSLE did not appear to influence either lupus activity (log rank p=0.227) or the probability of new onset lupus (log rank p=0.233). More than half of patients had NPSLE during the first year. The presence of cutaneous and articular signs, high lupus activity, and anti-nuclear factor were associated with the occurrence of NPSLE.