Causes and outcome of unconsciousness in the accident and emergency department of the university of Port Harcourt teaching hospital

Abstract

Background: Unconsciousness occurs when a patient enters a sleeplike state but cannot be aroused, and
it is not due to physiological drowsiness. It is a common presentation in the Accident and Emergency
Department (A&E), and a burden to the emergency physician especially when the cause is unknown. The
cause of coma may be trauma or non-trauma related. There is a shortage of data on the aetiology and
outcome of unconsciousness in developing countries including Nigeria.
Methodology: This cross-sectional study investigates 765 unconscious patients using convenience
sampling from September 2023 to June 2024 at the A&E of the University of Port Harcourt Teaching
Hospital. The World Health Organization emergency unit form was adapted for this study.
Results: The total population of this study is 765, 55.16% males and 44.84% females. A majority of the
cases 81.83% were not related to trauma. The commonest causes of unconsciousness were stroke,
diabetic complications & emergencies, traumatic brain injury, metastatic neoplasm, HIV AIDs related
disease and hypertensive emergency. Most of the patients 494(64.58%) died while in A&E, 116 (15.16%)
were transferred to the ward and 56 (7.58%) were discharged against medical advice.
Conclusion: Unconscious patients are a challenge in the emergency room. Stroke and diabetic
emergencies are the commonest causes of non-trauma-related aetiologies while traumatic brain injury is
the most common cause of trauma-related aetiology of unconsciousness.