Coma in the elderly: Etiological factors, management, and prognosis in the department of anesthesia and intensive care.

OBJECTIVE: To study the etiologies, therapeutic and prognosis factors of coma in the elderly in the Department of Anesthesia and Intensive Care of Gabriel TOURE Teaching Hospital, Mali.

MATERIALS AND METHODS: This was a prospective descriptive study of all cases of coma in the elderly, registered from February 1, 2008 to January 31, 2009 at the Department of Anesthesiology CHU Gabriel Touré, Bamako.

RESULTS: During the study period, 564 patients were admitted to the intensive care unit (ICU) in which 174 (30.85%) were older people. We collected 100 subjects with impaired consciousness, the object of our study, which represented 17.73% of all admissions in the Department of Anesthesiology during the study period and 57.47% of all admissions of older people; 66% of our subjects were male. Hypertensive patients accounted for 60% of cases. In 46% of cases, it was a coma from cardiovascular causes and in 28% of cases; it was a coma of metabolic origin. The diagnoses made in the wake of the care of the elderly in ICU were predominantly stroke (46%) and electrolyte disturbances (13%). The coma was sudden onset in 58% of cases, including 28 cases of stroke whether 48.27%. The prognosis was marked by a fatality with 51% of deaths in our sample.

CONCLUSION: The prognosis improvement of the elderly in coma through to the introduction of proxy measures.