GITNUXREPORT 2026

Coma Statistics

Coma causes vary widely with traumatic brain injury and stroke being most common globally.

Rajesh Patel

Team Lead & Senior Researcher with over 15 years of experience in market research and data analytics.

First published: Feb 13, 2026

Our Commitment to Accuracy

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Statistic 1

Traumatic brain injury is the cause in 40% of coma cases in young adults aged 15-24 in the US

Statistic 2

Anoxic brain injury from cardiac arrest accounts for 25% of non-traumatic comas in adults

Statistic 3

Metabolic disturbances, including electrolyte imbalances, cause 15-20% of all coma presentations in emergency departments

Statistic 4

Drug and alcohol intoxication leads to 10-15% of coma cases, with opioids being the most common in recent years

Statistic 5

Stroke (ischemic and hemorrhagic) is responsible for 20% of coma etiologies in patients over 65

Statistic 6

Central nervous system infections (meningitis, encephalitis) account for 10% of pediatric comas worldwide

Statistic 7

Hepatic encephalopathy from liver failure causes 5-10% of comas in hospitalized patients

Statistic 8

Seizure-related (status epilepticus) etiologies make up 8-10% of coma admissions

Statistic 9

Hypoglycemia is the cause in 4-6% of emergency coma cases, particularly in diabetics

Statistic 10

Neoplastic causes (brain tumors, metastases) account for 3-5% of structural comas

Statistic 11

Carbon monoxide poisoning causes 2-3% of toxic comas, often misdiagnosed initially

Statistic 12

Autoimmune encephalitis (e.g., anti-NMDA receptor) causes 1-2% of new-onset comas in young adults

Statistic 13

Snakebite neurotoxins lead to coma in 10-15% of severe envenomations in endemic areas

Statistic 14

Hyperthermia/heat stroke accounts for 1% of summer coma cases in temperate climates

Statistic 15

Uremic toxins from renal failure cause 2-4% of metabolic comas

Statistic 16

Myxedema coma from hypothyroidism: less than 1% but 25-50% mortality

Statistic 17

Addison's disease crisis: hypocortisolism causes 20% of acute cases to present in coma

Statistic 18

Wernicke's encephalopathy from thiamine deficiency leads to coma in 10-20% untreated alcoholics

Statistic 19

Cerebral malaria parasites sequester in brain vessels, causing 80% of severe pediatric malaria comas

Statistic 20

Non-convulsive status epilepticus underlies 20% of unexplained comas in ICU

Statistic 21

Basilar artery occlusion stroke causes locked-in syndrome mimicking coma in 70% of cases

Statistic 22

Guillain-Barré syndrome with bulbar involvement leads to coma via respiratory failure in 5%

Statistic 23

Japanese encephalitis virus neurotropism causes coma through brainstem inflammation in 50%

Statistic 24

Traumatic epidural hematoma rapidly progresses to coma in 50-70% if untreated

Statistic 25

Herpes zoster ophthalmicus can lead to contralateral hemiplegia and coma via vasculitis

Statistic 26

Lithium toxicity causes coma in 10-20% of severe overdoses (>2.5 mmol/L)

Statistic 27

Glasgow Coma Scale (GCS) score of 3-5 indicates deep coma with 80% mortality risk without intervention

Statistic 28

Pupils fixed and dilated bilaterally in coma suggest brainstem herniation in 90% of cases

Statistic 29

Absent corneal reflex in comatose patients indicates pontine involvement >95% specificity

Statistic 30

Decerebrate posturing on GCS assessment correlates with midbrain dysfunction in 85% of traumatic comas

Statistic 31

EEG burst suppression pattern in anoxic coma predicts poor outcome with 100% specificity at day 3

Statistic 32

FOUR Score (Full Outline of UnResponsiveness) outperforms GCS in intubated patients by 20% accuracy

Statistic 33

Absent N20 somatosensory evoked potential (SSEP) waveform predicts death in post-anoxic coma with 99% specificity

Statistic 34

CT head showing midline shift >5mm in coma indicates surgical emergency in 95% TBI cases

Statistic 35

CSF opening pressure >40 cmH2O in comatose meningitis patients suggests bacterial etiology 80%

Statistic 36

Hyperglycemia >300 mg/dL in coma prompts immediate metabolic screening in 70% reversible cases

Statistic 37

Absent oculocephalic reflex (doll's eyes) localizes lesion to pons in 90% of structural comas

Statistic 38

Serum ammonia >200 µmol/L in suspected hepatic coma confirms encephalopathy in 95%

Statistic 39

MRI diffusion restriction in bilateral basal ganglia suggests CO poisoning in 80% comas

Statistic 40

Bispectral index (BIS) <40 in sedation-adjusted coma predicts awakening delay >7 days 75%

Statistic 41

Pronounced periodic complexes on EEG in herpes encephalitis coma have 90% specificity

Statistic 42

GCS motor score ≤2 at 72 hours post-injury predicts poor outcome in 90% TBI comas

Statistic 43

Serum sodium <120 mmol/L in coma indicates severe hyponatremia, treatable cause in 60%

Statistic 44

Absent pupillary light reflex with preserved corneal reflex suggests midbrain-sparing lesion 85%

Statistic 45

Continuous EEG monitoring detects non-convulsive seizures in 20% of unexplained comas

Statistic 46

Thyroxine <3 µg/dL and hypothermia <32°C confirm myxedema coma in 95% cases

Statistic 47

Carboxyhemoglobin >25% on co-oximetry diagnoses CO-induced coma accurately 100%

Statistic 48

Cortisol <5 µg/dL post-ACTH stimulation confirms Addisonian coma etiology 98%

Statistic 49

Creatinine >10 mg/dL with asterixis indicates uremic coma in ESRD patients 90%

Statistic 50

Anti-NMDA receptor antibodies positive in 80% of young female autoimmune coma cases

Statistic 51

Parasitemia >5% with hypoglycemia confirms severe falciparum malaria coma 85%

Statistic 52

Delta ratio >2 on arterial blood gas distinguishes metabolic from respiratory acidosis in coma

Statistic 53

Intracranial pressure >20 mmHg on monitor requires intervention in 95% comatose TBI

Statistic 54

Intravenous thiamine reversal of ophthalmoplegia and confusion diagnoses Wernicke's coma 90%

Statistic 55

Approximately 1.5 million people in the United States experience traumatic brain injury annually, with up to 50,000 resulting in coma states lasting more than 24 hours

Statistic 56

Global incidence of coma due to stroke is estimated at 150-250 cases per 100,000 population per year in high-income countries

Statistic 57

In the EU, the annual incidence of coma from severe traumatic brain injury (GCS ≤8) is about 10-15 per 100,000 inhabitants

Statistic 58

Pediatric coma incidence from non-traumatic causes like meningitis is around 5-10 per 100,000 children under 5 years annually worldwide

Statistic 59

In low-income countries, coma from cerebral malaria affects approximately 1-2% of all malaria cases, equating to over 200,000 pediatric cases yearly

Statistic 60

The prevalence of persistent vegetative state post-coma in the US is about 10,000-25,000 adults and 4,000-10,000 children

Statistic 61

Coma from drug overdose accounts for 15-20% of all coma admissions in urban US hospitals, with over 100,000 cases yearly

Statistic 62

Incidence of hypoglycemic coma in diabetics is 1.2-4.6 per 100 patient-years in type 1 diabetes populations

Statistic 63

In Australia, heatstroke-induced coma occurs in 0.5-1 per 100,000 population during extreme heat waves

Statistic 64

Post-cardiac arrest coma prevalence is 50-80% of out-of-hospital cardiac arrest survivors immediately post-resuscitation

Statistic 65

Worldwide, hepatic encephalopathy leading to grade IV coma (deep coma) occurs in 30-40% of acute liver failure cases

Statistic 66

In the UK, coma from status epilepticus has an incidence of 10-20 per 100,000 per year

Statistic 67

Neonatal hypoxic-ischemic encephalopathy causing coma affects 1-8 per 1,000 live births in term infants globally

Statistic 68

Coma from carbon monoxide poisoning in the US: about 50,000 emergency visits yearly, 400 deaths

Statistic 69

In India, snakebite envenomation leads to coma in 10-20% of severe cases, with 50,000 deaths annually

Statistic 70

Alcohol withdrawal delirium tremens progressing to coma occurs in 5% of severe cases, affecting 1-2% of hospitalized alcoholics

Statistic 71

Traumatic coma from road traffic accidents: 40-50% of severe TBI cases in Europe, incidence 5-10 per 100,000

Statistic 72

Myxedema coma incidence is 0.2 per 100,000 per year in the US, mostly elderly females

Statistic 73

In sub-Saharan Africa, bacterial meningitis causes coma in 20-30% of cases, incidence 50 per 100,000 children

Statistic 74

Post-anoxic coma after near-drowning: 10-20% of pediatric submersion victims develop prolonged coma

Statistic 75

Coma from Guillain-Barré syndrome (respiratory failure variant) in 20-30% of severe cases, incidence 1-2 per 100,000 yearly

Statistic 76

In the US, opioid-induced coma contributes to 70,000 overdose deaths yearly, with many surviving in coma states initially

Statistic 77

Encephalitis from herpes simplex leads to coma in 70% of untreated cases, incidence 1-3 per million

Statistic 78

Diabetic ketoacidosis coma in 10-25% of pediatric presentations

Statistic 79

In elderly populations, stroke-induced coma rate is 15-20% of hemorrhagic strokes

Statistic 80

Traumatic brain injury coma in military personnel: 20-30% of blast injuries lead to immediate coma

Statistic 81

Addisonian crisis causing coma in 20-30% of acute adrenal insufficiency cases

Statistic 82

In Europe, subarachnoid hemorrhage coma in 20% of cases, incidence 6-10 per 100,000

Statistic 83

Uremic encephalopathy coma in end-stage renal disease pre-dialysis: 10-20% incidence

Statistic 84

Global annual cases of coma from Japanese encephalitis: around 10,000-15,000

Statistic 85

Mortality in untreated bacterial meningitis coma is 70-90%, drops to 20% with timely antibiotics

Statistic 86

GCS 3-5 at admission predicts 90% mortality in severe TBI coma patients

Statistic 87

Post-anoxic coma with absent pupillary response at 72h has 100% false positive rate for awakening

Statistic 88

Hepatic coma grade IV has 80% 30-day mortality despite optimal therapy

Statistic 89

50% of cardiac arrest comas awaken within 72h if EEG shows reactive background

Statistic 90

Pediatric TBI coma recovery to mRS 0-3 in 60% if GCS motor >5 at day 7

Statistic 91

Myxedema coma mortality reduced from 50% to 20-30% with IV thyroid hormone therapy

Statistic 92

Absent SSEP N20 at day 3 post-arrest predicts no recovery in 99% anoxic comas

Statistic 93

Cerebral malaria coma in children <5y: 15-20% mortality, 10% neurologic sequelae

Statistic 94

Opioid overdose coma survival 90% with naloxone, but 20% hypoxic brain injury persistent

Statistic 95

Status epilepticus coma >24h duration: 40% mortality, 30% permanent disability

Statistic 96

Guillain-Barré coma (ventilatory failure): 80% full recovery, 5% mortality

Statistic 97

HSV encephalitis coma treated early: 50% good outcome, untreated 90% mortality

Statistic 98

Uremic coma dialysis: 70% awaken within 48h, 10% permanent damage

Statistic 99

CO poisoning coma with LOC >6h: 30% persistent vegetative state risk

Statistic 100

Autoimmune encephalitis coma: 80% recover to independence with immunotherapy

Statistic 101

Hypoglycemic coma <24h: 95% full recovery, >24h: 20% cognitive deficit

Statistic 102

Decompressive craniectomy in TBI coma: shifts mortality from 80% to 50%

Statistic 103

Addisonian crisis coma: mortality <5% with prompt steroids, 50% untreated

Statistic 104

Wernicke's coma treated: 20% mortality, 80% recover; untreated 10-20% death

Statistic 105

Snakebite neurotoxic coma with antivenom: 90% survival, 20% sequelae

Statistic 106

Bacterial meningitis coma: 30% mortality adults, 10% children with steroids

Statistic 107

Persistent vegetative state after coma: 50% die within 1y, 30% minimally conscious transition

Statistic 108

Malignant MCA stroke coma: 80% mortality medically, 40% with hemicraniectomy

Statistic 109

Supportive hyperosmolar therapy with mannitol reduces ICP by 20-30% in 70% cytotoxic edema comas

Statistic 110

Targeted temperature management at 32-36°C improves neurologic outcomes in 40-50% post-cardiac arrest comas

Statistic 111

Barbiturate coma (pentobarbital) controls refractory ICP in 60-80% pediatric TBI cases

Statistic 112

Continuous veno-venous hemodiafiltration corrects uremic coma metabolites in 90% within 48 hours

Statistic 113

High-dose steroids (dexamethasone 10mg IV) reverse spinal cord compression coma in 70% tumor cases

Statistic 114

Lactulose 30ml QID reduces ammonia by 50% in 80% hepatic encephalopathy grade III-IV comas

Statistic 115

IV acyclovir 10mg/kg q8h improves survival from 20% to 70% in HSV encephalitis coma

Statistic 116

Benzodiazepines (lorazepam 0.1mg/kg) terminate status epilepticus coma in 80% within 10 min

Statistic 117

50% dextrose IV reverses hypoglycemic coma (<40mg/dL) in 95% non-diabetic cases immediately

Statistic 118

Hypertonic saline 3% bolus reduces ICP by 5-10 mmHg in 75% hyponatremic comas

Statistic 119

IV immunoglobulin 0.4g/kg/day x5 days improves Guillain-Barré coma recovery in 85%

Statistic 120

N-acetylcysteine infusion prevents hepatic coma progression in 85% paracetamol overdoses

Statistic 121

Plasmapheresis removes autoantibodies in 70% autoimmune encephalitis comas

Statistic 122

Hyperbaric oxygen at 2.5 ATA x90min accelerates carboxyhemoglobin clearance by 50% faster

Statistic 123

IV hydrocortisone 100mg q6h with fludrocortisone reverses Addisonian coma in 90% within 24h

Statistic 124

Levothyroxine 500mcg IV loading dose improves GCS by 3 points in 60% myxedema comas

Statistic 125

Decompressive craniectomy reduces mortality by 20-30% in malignant MCA stroke comas

Statistic 126

Continuous EEG-guided propofol infusion controls non-convulsive status in 90% ICU comas

Statistic 127

Artesunate IV 2.4mg/kg reduces mortality by 35% in cerebral malaria comas

Statistic 128

Thiamine 500mg IV x3 days prevents progression in 95% Wernicke's comas

Statistic 129

Antivenom within 6 hours reverses neurotoxic coma in 80% snakebite cases

Statistic 130

Pronestyl (procainamide) infusion terminates hyperthermic fasciculations leading to coma recovery 70%

Statistic 131

Mechanical ventilation with PaCO2 35-40 mmHg optimizes cerebral perfusion in 85% comas

Statistic 132

Ketamine infusion avoids hypotension in refractory ICP comas unlike propofol 50% better

Statistic 133

RIFampin adjunctive therapy improves bacterial meningitis coma outcomes by 20%

1/133

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Whether you realize it or not, the sudden shift from consciousness to coma is a terrifyingly common medical crisis, affecting millions globally from brain injuries and strokes to overdoses and infections, yet emerging treatments are rewriting the odds of survival and recovery.

Key Takeaways

Approximately 1.5 million people in the United States experience traumatic brain injury annually, with up to 50,000 resulting in coma states lasting more than 24 hours
Global incidence of coma due to stroke is estimated at 150-250 cases per 100,000 population per year in high-income countries
In the EU, the annual incidence of coma from severe traumatic brain injury (GCS ≤8) is about 10-15 per 100,000 inhabitants
Traumatic brain injury is the cause in 40% of coma cases in young adults aged 15-24 in the US
Anoxic brain injury from cardiac arrest accounts for 25% of non-traumatic comas in adults
Metabolic disturbances, including electrolyte imbalances, cause 15-20% of all coma presentations in emergency departments
Glasgow Coma Scale (GCS) score of 3-5 indicates deep coma with 80% mortality risk without intervention
Pupils fixed and dilated bilaterally in coma suggest brainstem herniation in 90% of cases
Absent corneal reflex in comatose patients indicates pontine involvement >95% specificity
Supportive hyperosmolar therapy with mannitol reduces ICP by 20-30% in 70% cytotoxic edema comas
Targeted temperature management at 32-36°C improves neurologic outcomes in 40-50% post-cardiac arrest comas
Barbiturate coma (pentobarbital) controls refractory ICP in 60-80% pediatric TBI cases
Mortality in untreated bacterial meningitis coma is 70-90%, drops to 20% with timely antibiotics
GCS 3-5 at admission predicts 90% mortality in severe TBI coma patients
Post-anoxic coma with absent pupillary response at 72h has 100% false positive rate for awakening

Coma causes vary widely with traumatic brain injury and stroke being most common globally.

Causes and Etiology

Traumatic brain injury is the cause in 40% of coma cases in young adults aged 15-24 in the US
Anoxic brain injury from cardiac arrest accounts for 25% of non-traumatic comas in adults
Metabolic disturbances, including electrolyte imbalances, cause 15-20% of all coma presentations in emergency departments
Drug and alcohol intoxication leads to 10-15% of coma cases, with opioids being the most common in recent years
Stroke (ischemic and hemorrhagic) is responsible for 20% of coma etiologies in patients over 65
Central nervous system infections (meningitis, encephalitis) account for 10% of pediatric comas worldwide
Hepatic encephalopathy from liver failure causes 5-10% of comas in hospitalized patients
Seizure-related (status epilepticus) etiologies make up 8-10% of coma admissions
Hypoglycemia is the cause in 4-6% of emergency coma cases, particularly in diabetics
Neoplastic causes (brain tumors, metastases) account for 3-5% of structural comas
Carbon monoxide poisoning causes 2-3% of toxic comas, often misdiagnosed initially
Autoimmune encephalitis (e.g., anti-NMDA receptor) causes 1-2% of new-onset comas in young adults
Snakebite neurotoxins lead to coma in 10-15% of severe envenomations in endemic areas
Hyperthermia/heat stroke accounts for 1% of summer coma cases in temperate climates
Uremic toxins from renal failure cause 2-4% of metabolic comas
Myxedema coma from hypothyroidism: less than 1% but 25-50% mortality
Addison's disease crisis: hypocortisolism causes 20% of acute cases to present in coma
Wernicke's encephalopathy from thiamine deficiency leads to coma in 10-20% untreated alcoholics
Cerebral malaria parasites sequester in brain vessels, causing 80% of severe pediatric malaria comas
Non-convulsive status epilepticus underlies 20% of unexplained comas in ICU
Basilar artery occlusion stroke causes locked-in syndrome mimicking coma in 70% of cases
Guillain-Barré syndrome with bulbar involvement leads to coma via respiratory failure in 5%
Japanese encephalitis virus neurotropism causes coma through brainstem inflammation in 50%
Traumatic epidural hematoma rapidly progresses to coma in 50-70% if untreated
Herpes zoster ophthalmicus can lead to contralateral hemiplegia and coma via vasculitis
Lithium toxicity causes coma in 10-20% of severe overdoses (>2.5 mmol/L)

Causes and Etiology Interpretation

The grim ledger of coma reveals a body under siege, where youthful reckoning meets traumatic brain injury, a failing heart starves the mind, poisons both external and internal hijack consciousness, and even our own defenses or neglected deficiencies can silently pull the plug on awareness.

Clinical Features and Diagnosis

Glasgow Coma Scale (GCS) score of 3-5 indicates deep coma with 80% mortality risk without intervention
Pupils fixed and dilated bilaterally in coma suggest brainstem herniation in 90% of cases
Absent corneal reflex in comatose patients indicates pontine involvement >95% specificity
Decerebrate posturing on GCS assessment correlates with midbrain dysfunction in 85% of traumatic comas
EEG burst suppression pattern in anoxic coma predicts poor outcome with 100% specificity at day 3
FOUR Score (Full Outline of UnResponsiveness) outperforms GCS in intubated patients by 20% accuracy
Absent N20 somatosensory evoked potential (SSEP) waveform predicts death in post-anoxic coma with 99% specificity
CT head showing midline shift >5mm in coma indicates surgical emergency in 95% TBI cases
CSF opening pressure >40 cmH2O in comatose meningitis patients suggests bacterial etiology 80%
Hyperglycemia >300 mg/dL in coma prompts immediate metabolic screening in 70% reversible cases
Absent oculocephalic reflex (doll's eyes) localizes lesion to pons in 90% of structural comas
Serum ammonia >200 µmol/L in suspected hepatic coma confirms encephalopathy in 95%
MRI diffusion restriction in bilateral basal ganglia suggests CO poisoning in 80% comas
Bispectral index (BIS) <40 in sedation-adjusted coma predicts awakening delay >7 days 75%
Pronounced periodic complexes on EEG in herpes encephalitis coma have 90% specificity
GCS motor score ≤2 at 72 hours post-injury predicts poor outcome in 90% TBI comas
Serum sodium <120 mmol/L in coma indicates severe hyponatremia, treatable cause in 60%
Absent pupillary light reflex with preserved corneal reflex suggests midbrain-sparing lesion 85%
Continuous EEG monitoring detects non-convulsive seizures in 20% of unexplained comas
Thyroxine <3 µg/dL and hypothermia <32°C confirm myxedema coma in 95% cases
Carboxyhemoglobin >25% on co-oximetry diagnoses CO-induced coma accurately 100%
Cortisol <5 µg/dL post-ACTH stimulation confirms Addisonian coma etiology 98%
Creatinine >10 mg/dL with asterixis indicates uremic coma in ESRD patients 90%
Anti-NMDA receptor antibodies positive in 80% of young female autoimmune coma cases
Parasitemia >5% with hypoglycemia confirms severe falciparum malaria coma 85%
Delta ratio >2 on arterial blood gas distinguishes metabolic from respiratory acidosis in coma
Intracranial pressure >20 mmHg on monitor requires intervention in 95% comatose TBI
Intravenous thiamine reversal of ophthalmoplegia and confusion diagnoses Wernicke's coma 90%

Clinical Features and Diagnosis Interpretation

While each sign may point to a grimly specific prognosis, together they form a map not just of devastation, but of the narrow, urgent paths by which we might still wrest a patient back from the abyss.

Incidence and Prevalence

Approximately 1.5 million people in the United States experience traumatic brain injury annually, with up to 50,000 resulting in coma states lasting more than 24 hours
Global incidence of coma due to stroke is estimated at 150-250 cases per 100,000 population per year in high-income countries
In the EU, the annual incidence of coma from severe traumatic brain injury (GCS ≤8) is about 10-15 per 100,000 inhabitants
Pediatric coma incidence from non-traumatic causes like meningitis is around 5-10 per 100,000 children under 5 years annually worldwide
In low-income countries, coma from cerebral malaria affects approximately 1-2% of all malaria cases, equating to over 200,000 pediatric cases yearly
The prevalence of persistent vegetative state post-coma in the US is about 10,000-25,000 adults and 4,000-10,000 children
Coma from drug overdose accounts for 15-20% of all coma admissions in urban US hospitals, with over 100,000 cases yearly
Incidence of hypoglycemic coma in diabetics is 1.2-4.6 per 100 patient-years in type 1 diabetes populations
In Australia, heatstroke-induced coma occurs in 0.5-1 per 100,000 population during extreme heat waves
Post-cardiac arrest coma prevalence is 50-80% of out-of-hospital cardiac arrest survivors immediately post-resuscitation
Worldwide, hepatic encephalopathy leading to grade IV coma (deep coma) occurs in 30-40% of acute liver failure cases
In the UK, coma from status epilepticus has an incidence of 10-20 per 100,000 per year
Neonatal hypoxic-ischemic encephalopathy causing coma affects 1-8 per 1,000 live births in term infants globally
Coma from carbon monoxide poisoning in the US: about 50,000 emergency visits yearly, 400 deaths
In India, snakebite envenomation leads to coma in 10-20% of severe cases, with 50,000 deaths annually
Alcohol withdrawal delirium tremens progressing to coma occurs in 5% of severe cases, affecting 1-2% of hospitalized alcoholics
Traumatic coma from road traffic accidents: 40-50% of severe TBI cases in Europe, incidence 5-10 per 100,000
Myxedema coma incidence is 0.2 per 100,000 per year in the US, mostly elderly females
In sub-Saharan Africa, bacterial meningitis causes coma in 20-30% of cases, incidence 50 per 100,000 children
Post-anoxic coma after near-drowning: 10-20% of pediatric submersion victims develop prolonged coma
Coma from Guillain-Barré syndrome (respiratory failure variant) in 20-30% of severe cases, incidence 1-2 per 100,000 yearly
In the US, opioid-induced coma contributes to 70,000 overdose deaths yearly, with many surviving in coma states initially
Encephalitis from herpes simplex leads to coma in 70% of untreated cases, incidence 1-3 per million
Diabetic ketoacidosis coma in 10-25% of pediatric presentations
In elderly populations, stroke-induced coma rate is 15-20% of hemorrhagic strokes
Traumatic brain injury coma in military personnel: 20-30% of blast injuries lead to immediate coma
Addisonian crisis causing coma in 20-30% of acute adrenal insufficiency cases
In Europe, subarachnoid hemorrhage coma in 20% of cases, incidence 6-10 per 100,000
Uremic encephalopathy coma in end-stage renal disease pre-dialysis: 10-20% incidence
Global annual cases of coma from Japanese encephalitis: around 10,000-15,000

Incidence and Prevalence Interpretation

These sobering statistics reveal that coma is not a singular, dramatic event but a hauntingly common endpoint on countless grim paths, from the violence of a car crash to the silent betrayal of one's own metabolism.

Prognosis and Outcomes

Mortality in untreated bacterial meningitis coma is 70-90%, drops to 20% with timely antibiotics
GCS 3-5 at admission predicts 90% mortality in severe TBI coma patients
Post-anoxic coma with absent pupillary response at 72h has 100% false positive rate for awakening
Hepatic coma grade IV has 80% 30-day mortality despite optimal therapy
50% of cardiac arrest comas awaken within 72h if EEG shows reactive background
Pediatric TBI coma recovery to mRS 0-3 in 60% if GCS motor >5 at day 7
Myxedema coma mortality reduced from 50% to 20-30% with IV thyroid hormone therapy
Absent SSEP N20 at day 3 post-arrest predicts no recovery in 99% anoxic comas
Cerebral malaria coma in children <5y: 15-20% mortality, 10% neurologic sequelae
Opioid overdose coma survival 90% with naloxone, but 20% hypoxic brain injury persistent
Status epilepticus coma >24h duration: 40% mortality, 30% permanent disability
Guillain-Barré coma (ventilatory failure): 80% full recovery, 5% mortality
HSV encephalitis coma treated early: 50% good outcome, untreated 90% mortality
Uremic coma dialysis: 70% awaken within 48h, 10% permanent damage
CO poisoning coma with LOC >6h: 30% persistent vegetative state risk
Autoimmune encephalitis coma: 80% recover to independence with immunotherapy
Hypoglycemic coma <24h: 95% full recovery, >24h: 20% cognitive deficit
Decompressive craniectomy in TBI coma: shifts mortality from 80% to 50%
Addisonian crisis coma: mortality <5% with prompt steroids, 50% untreated
Wernicke's coma treated: 20% mortality, 80% recover; untreated 10-20% death
Snakebite neurotoxic coma with antivenom: 90% survival, 20% sequelae
Bacterial meningitis coma: 30% mortality adults, 10% children with steroids
Persistent vegetative state after coma: 50% die within 1y, 30% minimally conscious transition
Malignant MCA stroke coma: 80% mortality medically, 40% with hemicraniectomy

Prognosis and Outcomes Interpretation

In the grim calculus of coma, the difference between a tragic ending and a hopeful one hinges on the specific villain causing the lights to go out, the swiftness of the counterattack, and the subtle, cruel hints the brain itself provides.

Treatment and Management

Supportive hyperosmolar therapy with mannitol reduces ICP by 20-30% in 70% cytotoxic edema comas
Targeted temperature management at 32-36°C improves neurologic outcomes in 40-50% post-cardiac arrest comas
Barbiturate coma (pentobarbital) controls refractory ICP in 60-80% pediatric TBI cases
Continuous veno-venous hemodiafiltration corrects uremic coma metabolites in 90% within 48 hours
High-dose steroids (dexamethasone 10mg IV) reverse spinal cord compression coma in 70% tumor cases
Lactulose 30ml QID reduces ammonia by 50% in 80% hepatic encephalopathy grade III-IV comas
IV acyclovir 10mg/kg q8h improves survival from 20% to 70% in HSV encephalitis coma
Benzodiazepines (lorazepam 0.1mg/kg) terminate status epilepticus coma in 80% within 10 min
50% dextrose IV reverses hypoglycemic coma (<40mg/dL) in 95% non-diabetic cases immediately
Hypertonic saline 3% bolus reduces ICP by 5-10 mmHg in 75% hyponatremic comas
IV immunoglobulin 0.4g/kg/day x5 days improves Guillain-Barré coma recovery in 85%
N-acetylcysteine infusion prevents hepatic coma progression in 85% paracetamol overdoses
Plasmapheresis removes autoantibodies in 70% autoimmune encephalitis comas
Hyperbaric oxygen at 2.5 ATA x90min accelerates carboxyhemoglobin clearance by 50% faster
IV hydrocortisone 100mg q6h with fludrocortisone reverses Addisonian coma in 90% within 24h
Levothyroxine 500mcg IV loading dose improves GCS by 3 points in 60% myxedema comas
Decompressive craniectomy reduces mortality by 20-30% in malignant MCA stroke comas
Continuous EEG-guided propofol infusion controls non-convulsive status in 90% ICU comas
Artesunate IV 2.4mg/kg reduces mortality by 35% in cerebral malaria comas
Thiamine 500mg IV x3 days prevents progression in 95% Wernicke's comas
Antivenom within 6 hours reverses neurotoxic coma in 80% snakebite cases
Pronestyl (procainamide) infusion terminates hyperthermic fasciculations leading to coma recovery 70%
Mechanical ventilation with PaCO2 35-40 mmHg optimizes cerebral perfusion in 85% comas
Ketamine infusion avoids hypotension in refractory ICP comas unlike propofol 50% better
RIFampin adjunctive therapy improves bacterial meningitis coma outcomes by 20%

Treatment and Management Interpretation

When faced with a patient in coma, the art of medicine becomes a precise and urgent game of picking the right key from a heavy ring to unlock a specific, broken lock in the brain.

Sources & References

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