Analysis of factors associated with poor prognosis in patients with severe neurological coma

Abstract:

Objective：To explore related factors of poor prognosis in patients with severe neurological coma. Methods：A total of 117 patients with coma [Glasgow coma score（GCS）≤8] were included from January 2017 to April 2018 in The First Affiliated Hospital of Chongqing Medical University with the retrospective investigation method，and were divided into the survival group（n=74） and the death group（n=43） according to the Glasgow outcome score（GOS） when discharged. Data of included patients were retrospectively analyzed by specific person and analytical data included medical history data（gender，age，diagnosis and organs with incomplete function），disease assessment data[GCS score，acute physiology and chronic health evaluation（APACHE） Ⅱ score]，EEG indicator （EEG pattern within 72 hours of onset，basic background，amplitude characteristics，Synek grading by EEG background and amplitude characteristics，reactivity and sleep wave），and biochemical indicators within 72 hours（Na+，K+，Cl-，Ca2+，albumin，lactic acid and etc.）. Results：Logistic regression analysis showed that OR value of EEG reactivity was 4.717，95%CI=1.333 to 16.686；OR value of age was 1.057，95%CI=1.020 to 1.095；OR value of APACHE Ⅱ score was 1.201，95%CI=1.082 to 1.334；OR value of GCS score was 4.705，95%CI=1.322 to 16.743；all values were P<0.05. Conclusion：EEG reactivity，age，APACHE Ⅱ score，GCS score have association with death risks in acute phase in patients with severe neurological coma. In the clinical，we should pay close attention to those indicators，so as to make timely，objective and comprehensive prognostic judgments on patients.