Survey study of the etiology of non-traumatic altered consciousness in the Emergency Department at Suez Canal University Hospital in Egypt

doi:10.12998/wjcc.v11.i6.1310

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World Journal of Clinical Cases

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2307-8960

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Clin Cases. Feb 26, 2023; 11(6): 1310-1317
Published online Feb 26, 2023. doi: 10.12998/wjcc.v11.i6.1310

Survey study of the etiology of non-traumatic altered consciousness in the Emergency Department at Suez Canal University Hospital in Egypt

Bassant S Moussa, Zeinab M Abd Elatiff, Ghada M Kamal Eldin Elhadary

Bassant S Moussa, Zeinab M Abd Elatiff, Ghada M Kamal Eldin Elhadary, Emergency Medicine Department, Suez Canal University, Faculty of Medicine, Ismailia 41522, Egypt

Author contributions: Moussa BS and Abd Elatiff ZM collected the data; Moussa BS assessed the results; Kamal Eldin Elhadary GM and Abd Elatiff ZM wrote and revised the manuscript; all authors read and approved the final manuscript.

Institutional review board statement: Ethics approval and consent to participate were obtained from the Ethical Committee of the Faculty of Medicine of Suez Canal University.

Conflict-of-interest statement: All the authors declare having no conflicts of interest.

Data sharing statement: All data generated or analyzed during this study are included in this published article and supplementary materials section.

Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Bassant S Moussa, PhD, Senior Lecturer, Emergency Medicine Department, Suez Canal University, Faculty of Medicine, Ring Road, Ismailia 41522, Egypt. bassant_sayed@med.suez.edu.eg

Received: October 14, 2022
Peer-review started: October 14, 2022
First decision: December 13, 2022
Revised: January 6, 2022
Accepted: February 3, 2023
Article in press: February 3, 2023
Published online: February 26, 2023

ARTICLE HIGHLIGHTS

Research background

Disorders of consciousness including coma in non-traumatic patients can be caused by a wide variety of pathologies affecting the central nervous system including life-threatening medical, neurological or neurosurgical emergencies where timely medical intervention is vital. The early treatment of these patients is vital, and diagnoses need to be confirmed or excluded promptly.

Research motivation

There are no data on the pattern of altered consciousness presentation in Emergency Departments (EDs) in Egypt, which could make proper preparation for the potential needs of these patients suboptimal.

Research objectives

The primary objective of our study was to identify the causes of altered consciousness presentation to the ED at Suez Canal University Hospital (Egypt). The secondary objectives were to describe the treatment modalities for patients presenting with altered consciousness and to assess the mortality rate among patients presenting with altered consciousness.

Research methods

This study was conducted on 87 patients, all of whom were ≥ 18-year-old with acute non-traumatic disturbed level of consciousness (DLOC) i.e. Glasgow coma scale < 15. All data of the patients included in this study had been collected after receiving informed written consent from the patients’ first-degree relatives. The outcomes of the patients were determined as survival or death, and the mortality rate was calculated.

Research results

In our study, the most common cause of acute non-traumatic DLOC was systemic infection such as sepsis and septic shock (n = 22, 25.3%), followed by respiratory causes (n = 21, 24.1%) and neurological causes (n = 16, 18.4%). The mortality rate was 25.3% (n = 22) of which 41.0% of the patients died due to systemic infection, followed by 31.8% due to respiratory causes [primarily coronavirus disease 2019 (COVID-19)] and 13.6% due to oncological causes.

Research conclusions

The most common cause of acute non-traumatic DLOC was systemic infections followed by respiratory and neurological causes.

Research perspectives

Further study and analysis are needed to overcome the challenges of a small sample size and outbreaks of COVID-19 encountered in our study.