Background : Coma occurring in the course of an illness, irrespective
of cause, traditionally implies a poor prognosis and many factors may
determine its outcome. These factors must be identified and possibly
stratified in their order of importance. This research seeks to
identify these factors and how they influenced the outcome of
non-traumatic coma in our environment. Methods : Two hundred
consecutive patients, aged 18-79 years who met the inclusion criteria,
the Glasgow coma scale (GCS) score of < 8, history and physical
findings suggestive of medical illness, no head trauma or sedation,
were recruited into the study from August 2004 to March 2005 at the
University College Hospital (UCH), Ibadan, after obtaining
institutional ethical clearance and consent from patients′
guardians. Detailed history of illness including the bio-data and time
to present to the hospital and treatments given were noted. Thereafter,
the clinical course of the patients was monitored daily for a maximum
of 28 days during which the support of the family and/ or the hospital
social welfare was evaluated. Results : During the 8-month period of
the study, 76% (152) of the patients died while 24% (48) survived. The
following factors were associated with high mortality rate: inability
to confirm diagnosis (100%), poor family support (97.1%), delay in
making a diagnosis within 24 h (85.4%), poor family understanding of
disease (84.1%), need for intensive care admission and management
(83.3%), poor hospital social welfare support (82.4%), presentation to
UCH after 6 h of coma (76.7%), and referral from private health
facilities (75.7%). Others include substance abuse (100%) and
seropositivity to HIV (96%) and hepatitis B surface antigen (92%)
antibodies, among others. Conclusion : This study has demonstrated that
socio-economic factors such as gender, occupation, risky lifestyle
behaviors, late presentation or referral to hospital, late diagnosis
and treatment, and poor family support contributed to poor outcome of
nontraumatic coma. It is hoped that improvement, modification, or
correction of these factors may improve coma outcome