Materiały źródłowe

• #1 Incidence and prevalence of coma in the UK and the USA

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9486895/

  The epidemiology of coma is unknown because case ascertainment with traditional methods is difficult. Here, we used crowdsourcing methodology to estimate the incidence and prevalence of coma in the UK and the USA. […] We found more coma cases in the USA (n=47) than in the UK (n=20; P=0.009). We identified one coma case in the UK (0.007%, 95% confidence interval 0.000.04%) on the day of the survey and 19 new coma cases (0.13%, 95% confidence interval 0.080.21%) within the preceding year, resulting in an annual incidence of 135/100000 (95% confidence interval 81210) and a point prevalence of 7 cases per 100000 population (95% confidence interval 0.1839.44) in the UK. We identified five cases in the USA (0.031%, 95% confidence interval 0.010.07%) on the day of the survey and 42 new cases (0.26%, 95% confidence interval 0.190.35%) within the preceding year, resulting in an annual incidence of 258/100000 (95% confidence interval 186349) and a point prevalence of 31 cases per 100000 population (95% confidence interval 9.9871.73) in the USA.

• #2 Incidence and prevalence of coma in the UK and the USA

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9486895/

  To summarize, for the first time, we report incidence and prevalence estimates for coma across diagnosis types and settings in the UK and the USA using crowdsourcing methods. Coma may be more prevalent in the USA than in the UK, which requires further investigation. These data are urgently needed to expand the public health perspective on coma and disorders of consciousness.

• #3 Incidence and prevalence of coma in the UK and the USA.

  https://escholarship.org/uc/item/3gq4p9jr

  The epidemiology of coma is unknown because case ascertainment with traditional methods is difficult. Here, we used crowdsourcing methodology to estimate the incidence and prevalence of coma in the UK and the USA. […] To summarize, for the first time, we report incidence and prevalence estimates for coma across diagnosis types and settings in the UK and the USA using crowdsourcing methods. Coma may be more prevalent in the USA than in the UK, which requires further investigation. These data are urgently needed to expand the public health perspective on coma and disorders of consciousness.

• #4 Azthena logo with the word Azthena

  https://www.news-medical.net/news/20220906/Study-reveals-first-epidemiologic-data-on-coma-in-the-UK-and-the-US.aspx

  A newly-published study conducted jointly by eighteen neuroscientists from the United States and Europe including two researchers from The Ohio State University College of Nursing and Wexner Medical Center and using crowdsourcing as an information-gathering method reveals the first epidemiologic data on coma in the United Kingdom and the U.S. […] The annual incidence of coma was nearly twice as high in the United States (258 per 100,000 population) as in the U.K. (135 per 100,000). […] The incidence of coma (2 in 1,000 people per year) appears high when compared with commonly encountered conditions such as sepsis. […] „Having this data at our disposal is critical not only in our understanding of the incidence of coma, but also in how we approach the condition at the bedside,” said Thomas Lawson, MS, lead advanced practice provider in the Neurocritical Care Unit at The Ohio State University Wexner Medical Center who is also a co-author and a PhD candidate at the College of Nursing. […] The study was sponsored by the Neurocritical Care Society’s Curing Coma Campaign which, according to its website, „is the first global public health initiative to tackle the unifying concept of coma as a treatable medical entity.”

• #5 Ohio State researchers involved in first-of-its-kind global study on prevalence of coma | The Ohio State University College of Nursing

  https://nursing.osu.edu/news/2022/09/06/ohio-state-researchers-involved-first-its-kind-global-study-prevalence-coma

  Ohio State researchers involved in first-of-its-kind global study on prevalence of coma […] A newly-published study conducted jointly by eighteen neuroscientists from the United States and Europe including two researchers from The Ohio State University College of Nursing and Wexner Medical Center and using crowdsourcing as an information-gathering method reveals the first epidemiologic data on coma in the United Kingdom and the U.S. […] The annual incidence of coma was nearly twice as high in the United States (258 per 100,000 population) as in the U.K. (135 per 100,000). […] The five most common causes of coma in family members were identified as stroke, medically-induced coma, COVID-19, traumatic brain injury and cardiac arrest. […] The incidence of coma (2 in 1,000 people per year) appears high when compared with commonly encountered conditions such as sepsis.

• #6 Myxedema Coma or Crisis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/123577-overview

  Myxedema coma typically occurs in patients with long-lasting, previously undiagnosed hypothyroidism and is generally precipitated by infection, congestive heart failure, acute myocardial infarction, cerebrovascular accident, gastrointestinal bleeding, or medications. […] Hypothyroidism is one of the most common endocrine disorders, affecting 11.7% of the US population. However, myxedema coma is rare (with the precise prevalence unknown), likely due to the common availability thyroid function testing and, therefore, the widespread early detection of hypothyroidism. […] In areas where there is an adequate intake of iodine, the most common cause of hypothyroidism is autoimmune thyroid disease, with a prevalence that varies from 5.6% to 11.4%. In regions where inadequate amounts of iodine are ingested, the most common cause of hypothyroidism is iodine deficiency. Severe hypothyroidism is observed only with severe iodine deficiency, which is generally found in isolated, mountainous regions of South America, Africa, and Asia. An observational study showed that the estimated incidence of myxedema coma in Japan was 1.08 per million people per year.

• #7 Hypothyroidism and Myxedema Coma: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/768053-overview

  Myxedema coma occurs rarely, reportedly appearing in 0.1% of all cases of hypothyroidism. […] However, using the US National (Nationwide) Inpatient Sample, a study by Chen et al found that myxedema coma was diagnosed in 13.4% of 18,635 patients hospitalized for hypothyroidism. […] In developed countries, the incidence of subclinical hypothyroidism is approximately 8% in women and 3% in men. […] A study by Ono et al estimated the annual incidence of myxedema coma in Japan to be 1.08 per million people.

• #8 Epidemiology of acute diabetes complications (coma) according to the Federal Diabetes register of the Russian Federation (2013–2016) | Mayorov | Diabetes mellitus

  https://www.dia-endojournals.ru/jour/article/view/10028?locale=en_US

  Despite the improvement in the quality of diabetes care in the Russian Federation (RF), coma remain one of the causes of death in patients with diabetes. […] In 2016, the prevalence of coma in RF was 225.9 with T1D and 11.6/10000 adults with T2D. […] The frequency of new cases of coma has a tendency to decrease: 0,90,4/10000 adults: T1D 5.73.4, T2D 0.60.2/10000 adults. […] It is established that the dynamics of the frequency of development of coma in 201316 in adult patients with diabetes in the RF has a stable tendency to decrease: 1.5 times with T1D and more than 3 times with T2D. […] Attention is required to draw to the high frequency of coma in T1D, the development of coma with a longer duration of diabetes, an increase in the proportion of patients with hypoglycemic coma. Significant interregional differences in the frequency of coma registration require additional analysis.

• #9 (PDF) Incidence, aetiology, and outcome of non-traumatic coma: a population based study

  https://www.academia.edu/34393441/Incidence_aetiology_and_outcome_of_non_traumatic_coma_a_population_based_study

  Aim-To determine the incidence, presentation, aetiology, and outcome of nontraumatic coma in children aged between 1 month and 16 years. […] The incidence of non-traumatic coma was 30.8 per 100 000 children under 16 per year (6.0 per 100 000 general population per year). […] Infection was the commonest overall aetiology. […] Aetiology remained unknown in 14% despite extensive investigation and/or autopsy. […] Mortality was highly dependent on aetiology, with aetiology specific mortality rates varying from 3% to 84%. […] With follow up to approximately 12 months, overall series mortality was 46%. […] Non traumatic coma in childhood is an important emergency. It can result from wide range of etiologies. CNS infections are the most common cause of non traumatic coma in children. […] The most common causes of loss of consciousness among children were as follows: toxic causes in 61 patients (49.6%), infectious causes in 30 patients (24.4%), metabolic causes in 11 patients (8.9%), structural brain abnormalities in 4 patients (3.3%) and seizure in 7 children (5.7%).

• #10 The Curing Coma Campaign International Survey on Coma Epidemiology, Evaluation, and Therapy (COME TOGETHER).

  https://www.repository.cam.ac.uk/items/dd9ba2ef-f5fe-4bf2-adb3-5bacbac6ff7b

  BACKGROUND: Although coma is commonly encountered in critical care, worldwide variability exists in diagnosis and management practices. […] We aimed to assess variability in coma definitions, etiologies, treatment strategies, and attitudes toward prognosis. […] The survey was completed by 258 health care professionals from 41 countries. […] Among eight predefined items, respondents identified the following cardinal features, in various combinations, that must be present to define coma: absence of wakefulness (81%, =0.764); Glasgow Coma Score (GCS)8 (64%, =0.588); failure to respond purposefully to visual, verbal, or tactile stimuli (60%, =0.552); and inability to follow commands (58%, =0.529). […] Reported etiologies of coma encountered included medically induced coma (24%), traumatic brain injury (24%), intracerebral hemorrhage (21%), and cardiac arrest/hypoxic-ischemic encephalopathy (11%).

• #11

  https://link.springer.com/article/10.1007/s12028-023-01852-9

  The limited representation from developing countries in the original COME TOGETHER survey gave us an impetus to conduct this survey in the Indian subcontinent. […] This cross-sectional online survey was conducted from August through September 2022. Participants were health care physicians caring for patients with coma and disorders of consciousness. […] The survey was completed by 130 physicians. We found substantial interrater agreement on absence of wakefulness (71.54%; =0.71), Glasgow Coma Score8 (78.46%; =0.78), and failure to respond purposefully to visual, verbal, or tactile stimuli (66.15%; =0.66). Reported common etiologies of coma included traumatic brain injury (50.76%), ischemic stroke (30%), and intracerebral hemorrhage (29.23%). […] Differences from the global survey were noted regarding the following: traumatic brain injury being the most common etiology of coma in India, more frequent practice of sedation interruption, less frequent use of electroencephalography in India, rare use of pharmacological neurostimulants, and home being the most common discharge disposition in India.

• #12 A National Survey on Coma Epidemiology, Evaluation and Therapy in India – Revisiting The Curing Coma® Campaign COME TOG…

  https://ouci.dntb.gov.ua/en/works/4LN8VbK9/

  A National Survey on Coma Epidemiology, Evaluation and Therapy in India – Revisiting The Curing Coma® Campaign COME TOGETHER Survey […] The primary aim of carrying out this survey across various hospital settings in India was to assess variability of defining coma clinical features, it’s etiology and to identify the current practice for diagnosis, management, and prognostication of comatose patients. […] The survey was completed by 130 health care physicians, majority of them were trained in critical care medicine (70.8%) or neurocritical care (37.7%). […] Reported common etiologies of coma include traumatic brain injury (50.76%), ischemic stroke (30%) and intracerebral hemorrhage (29.23%). […] Differences from global survey were noted regarding TBI being the commonest etiology of coma, more frequent practice of sedation interruption, less frequent use of EEG in India, rare use of pharmacological neuro-stimulants and common discharge disposition in India being home. […] The LMIC’s face shortage in health resources, diagnostic facilities and trained specialists making it worthwhile to study the challenges and practices in these countries.

• #13 Coma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430722/

  Coma is a common clinical presentation to the emergency department (ED), but the actual frequency of coma at ED presentation is difficult to determine. The number of published studies of patients presenting with coma is surprisingly small. […] A more recent single-center study of over 1000 consecutive patients with coma of unknown etiology that excluded traumatic brain injury and cardiac arrest survivors found that patients with coma of unknown etiology comprised 0.4% of all ED patients. The main diagnoses were classified into acute primary brain lesions such as hemorrhage and tumors (39%), primary brain pathologies without acute lesions, largely epilepsy (25%), and pathologies that affected the brain secondarily such as sepsis, intoxications, or metabolic conditions (36%). One-third of subjects had more than one coma-explaining pathology.

• #14 Coma | 5-Minute Pediatric Consult

  https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617759/all/Coma?q=LORazepam

  Coma is defined as a state in which the patient appears to be asleep, shows no awareness of his or her surroundings, and cannot be aroused. […] Incidence varies by age, season (infection), and ethnicity (inborn errors of metabolism [IEM]). […] Coma etiology can be traumatic or nontraumatic. Infection is a common cause of nontraumatic coma.

• #15 (PDF) Incidence, aetiology, and outcome of non-traumatic coma: a population based study

  https://www.academia.edu/34393441/Incidence_aetiology_and_outcome_of_non_traumatic_coma_a_population_based_study

  The cerebro-vascular accidents was the commonest causes of non-traumatic coma 17 (34%), other etiological factor found were cerebral malaria 10 (20%), hepatic coma 4 (8%) and diabetic ketoacidosis 4(8%). […] The outcomes of 60 children unconscious for 90 days or longer following acquired brain injury are reported. […] The most common cause of coma were diseases that cause no focal neurologic deficit (FND), occurring in 31 (58.5%) patients. […] Among the causes with non-localizing signs, the most common causes were intoxications, uremic and hepatic encephalopathies, occurring in 11 (20.8%), 7 (13.2%), and 5 (9.4%) of the patients, respectively. […] Medical coma, regardless of the etiology, was associated with high mortality rate.

• #16 Coma – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/coma/symptoms-causes/syc-20371099

  Coma is a medical emergency. Quick action is needed to preserve life and brain function. […] A coma is a medical emergency. Seek immediate medical care for the person in a coma. […] Many types of problems can cause a coma. […] The risk of coma goes up with age. This is especially true if older adults: […] Although many people gradually recover from a coma, others enter a persistent vegetative state or die. Some people who recover from a coma end up with major or minor disabilities.

• #17 Metabolic encephalopathy and metabolic coma | MedLink Neurology

  https://www.medlink.com/articles/metabolic-encephalopathy-and-metabolic-coma

  Epidemiology […] A metaanalysis shows prevalence ranging from 4% to 31% of hospitalized patients. Other data, interpreted from rates of delirium, show that prevalence is higher in hospitals, and highest in intensive care units. Cohort studies demonstrate that delirium is found in 60-80% of mechanically ventilated patients, and 20% to 50% of nonventilated patients. […] An observational study conducted in 251 elderly patients (mean age of 70.78 years) over 1 year demonstrated that metabolic causes were the etiology of the encephalopathy in 84 (33.47%) of those patients. Among those patients, hyponatremia was the most common cause of metabolic encephalopathy followed by hypoglycemia.

• #18 Myxedema Coma: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/1201/p2485.html

  Myxedema coma, the extreme manifestation of hypothyroidism, is an uncommon but potentially lethal condition. […] Most authorities recommend treatment with intravenous levothyroxine (T4) as opposed to intravenous liothyronine (T3). […] Myxedema coma occurs almost exclusively in persons 60 years and older. […] More than 90 percent of cases occur during the winter months. […] While the actual prevalence of myxedema coma is unknown, its lethal nature demands recognition. Even with early detection and appropriate treatment, mortality ranges from 30 to 60 percent. […] Family physicians must be alert to the possibility of undiagnosed hypothyroidism in their patients. […] Family physicians should be alert for myxedema coma, particularly in elderly women with mental status changes who present during the winter months. An accurate diagnosis generally follows a careful history, physical examination and laboratory evaluation. The most important elements in treatment of myxedema coma are early recognition, presumptive thyroid hormone replacement, hydrocortisone and appropriate supportive care. While myxedema coma carries a significant mortality rate even with appropriate testing and treatment, an early diagnosis of hypothyroidism may well save a patient’s life.

• #19 The Curing Coma Campaign International Survey on Coma Epidemiology, Evaluation, and Therapy (COME TOGETHER).

  https://www.repository.cam.ac.uk/items/dd9ba2ef-f5fe-4bf2-adb3-5bacbac6ff7b

  The most common clinical assessment tools used for coma included the GCS (94%) and neurological examination (78%). […] Sixty-six percent of respondents routinely performed sedation interruption, in the absence of contraindications, for clinical coma assessments in the intensive care unit. […] The leading determinants for prognostication included etiology of coma, neurological examination findings, and neuroimaging. […] There is wide heterogeneity among health care professionals regarding the clinical definition of coma and limited routine use of advanced coma assessment techniques in acute care settings. […] Coma management practices vary across sites, and mechanisms for coordinated and sustained follow-up after acute treatment are inconsistent. […] There is an urgent need for the development of evidence-based guidelines and a collaborative, coordinated approach to advance both the science and the practice of coma management globally.

• #20 EEG in postanoxic coma: prognostic and diagnostic value – University of TampaSpartacus Chatbot

  http://ut.primo.exlibrisgroup.com/discovery/fulldisplay?docid=cdi_proquest_miscellaneous_1773431085&context=PC&vid=01UTAMPA_INST:SpartanSearch&lang=en&search_scope=MyInst_and_CI&adaptor=Primo%20Central&tab=Everything&query=sub%2Cexact%2CComa&offset=100

  EEG in postanoxic coma: prognostic and diagnostic value […] Coma – epidemiology […] Coma – diagnosis […] Coma – physiopathology […] Hypoxia-Ischemia, Brain – epidemiology […] Highlights • Low voltage (<20 μV) and burst-suppression with identical bursts EEG at 24 hours after cardiac arrest invariably predict poor outcome. • Continuous EEG patterns with physiological rhythms within 12 hours are strongly associated with a good outcome. • Epileptiform patterns, including electrographic status epilepticus, are of unknown significance, and treatment effects are indistinct.

• #21

  https://link.springer.com/article/10.1007/s12028-021-01425-8

  Although coma is commonly encountered in critical care, worldwide variability exists in diagnosis and management practices. […] The primary objective of the Coma Epidemiology, Evaluation, and Therapy (COME TOGETHER) survey was to assess international variability of defining coma clinical features and etiology and to identify current practices for diagnosis, management, and prognosis of comatose patients across underlying disease and mechanisms of coma. […] There is wide heterogeneity among health care professionals regarding the clinical definition of coma and limited routine use of advanced coma assessment techniques in acute care settings. […] Coma management practices vary across sites, and mechanisms for coordinated and sustained follow-up after acute treatment are inconsistent. […] The leading determinants for prognostication included etiology of coma, neurological examination findings, and neuroimaging.

• #22 Some People Who Appear to Be in a Coma May Actually Be Conscious | Scientific American

  https://www.scientificamerican.com/article/some-people-who-appear-to-be-in-a-coma-may-actually-be-conscious/

  Some people think comas are easy to recover from or conversely a living death. Both are mistakes. […] As many as 15 to 20 percent of patients who appear to be in a coma or other unresponsive state show these inner signs of awareness when evaluated with advanced brain-imaging methods or sophisticated monitoring of electrical activity. […] The standard definition of a comatose patient is someone who is unconscious, is unable to be awakened, and has no signs of awareness or the ability to interact with the environment. […] Detecting and predicting recovery of consciousness early on, in the intensive care unit, is often a matter of life or death. […] The early detection of covert consciousness, soon after a patient’s injury, predicts behavioral recovery of consciousness, long-term functional recovery and the speed of that recovery, as shown by the research that our group published in 2019.

• #23 Risk factors for death in patients with myxedema coma

  https://www.thyroid.org/patient-thyroid-information/ct-for-patients/april-2017/vol-10-issue-4-p-3-4/

  Approximately 19 million hospital admissions were recognized during the study period of which 149 were for myxedema coma. The average age of patients with myxedema coma was 77, 2/3rd of patients were females and highest number of patients were admitted in winter months. Overall 29.5% of patients died while in hospital. The overall frequency of myxedema coma in the Japanese population was estimated to be 1.08 per million people per year. Patients who were older and required treatment for low blood pressure with catecholamine medications had the highest death rate while in hospital. […] In summary, this study showed that myxedema coma in Japan is indeed rare, affecting ~1 patient/million people. Almost 30% of patients with myxedema coma will die and the chance of dying from is higher for patients who are older and treated with catecholamine medications for low blood pressure. This study provides knowledge about the most vulnerable patients at risk of death due to myxedema coma.

• #24 Death after awakening from post-anoxic coma: the “Best CPC” project | Critical Care | Full Text

  https://ccforum.biomedcentral.com/articles/10.1186/s13054-019-2405-x

  In patients who recover consciousness after cardiac arrest (CA), a subsequent death from non-neurological causes may confound the assessment of long-term neurological outcome. […] We investigated the prevalence and causes of death after awakening (DAA) in a multicenter cohort of CA patients. […] In this large multicenter cohort, DAA was observed in 4.2% of non-survivors. Information on DAA is crucial since it may influence epidemiology and the design of future CA studies evaluating neuroprognostication and neuroprotection. […] The results of this multicenter study showed that 4.2% of comatose CA survivors admitted to ICU die after regaining consciousness. […] These findings should be reported in neuroprognostication studies and may be helpful for the design of future trials assessing neuroprotective interventions.

• #25 Some People Who Appear to Be in a Coma May Actually Be Conscious | Scientific American

  https://www.scientificamerican.com/article/some-people-who-appear-to-be-in-a-coma-may-actually-be-conscious/

  Neurologists are trying to devise a test that can identify which patients are likely to be in a state of covert consciousness and thus should undergo advanced EEG and functional MRI assessments. […] Communication might be possible using functional MRI, too. […] There is no mystery, however, about the ethical imperative that physicians now have to search for consciousness in patients who appear unresponsive, using all available technologies and resources.

• #26

  https://link.springer.com/article/10.1007/s12028-021-01425-8

  The most common pharmacologic interventions to stimulate arousal in patients with coma (24 h) were sedation vacation or sedation reversal and the use of neurostimulants (amantadine, modafinil, methylphenidate). […] The majority of respondents indicated that future research for coma patients should focus on treatment, prognostication, pathophysiology, and diagnostics.

• #27 Shorter Therapeutic Coma in Refractory Status Epilepticus May Be Safer, More Effective

  https://www.neurologylive.com/view/shorter-duration-of-therapeutic-coma-in-refractory-status-epilepticus-may-be-safer-more-effective

  A shorter yet deeper therapeutic coma for treatment of refractory status epilepticus may be more effective and safer than the currently recommended therapeutic coma duration of 24 to 48 hours. […] In a recent retrospective, observational cohort study, investigators concluded that a shorter, yet deeper therapeutic coma may be safer and more effective than the currently recommended therapeutic coma duration of 24 to 48 hours for refractory status epilepticus. […] Our study suggests that an initial trial of therapeutic coma with a duration of greater than 35 hours can be associated with an increased risk for seizure recurrence following the anesthetic wean. […] Our findings suggest that clinicians should consider the duration and depth of therapeutic coma when managing patients with refractory status epilepticus and should try to expose the patient for the shortest time possible with an adequately deep therapeutic coma throughout the entire duration of treatment.

• #28 Cerebral Malaria: Mechanisms of Brain Injury and Strategies for Improved Neurocognitive Outcome | Pediatric Research

  https://www.nature.com/articles/pr2010173

  Thus, other than causing thousands of deaths, cerebral malaria is now considered a leading cause of neurodisability in African children. […] The mechanisms of neural injury in cerebral malaria are poorly understood. […] A fundamental problem in assessment of cerebral malaria pathogenesis is the relative paucity of CNS pathologic or physiologic data in humans. […] Sequestration impairs local perfusion and may cause hypoxic injury. […] The extent of brain injury may depend on causation of coma, degree of microvascular obstruction, and inflammatory response; duration of exposure, presence of concurrent complications such as shock, and availability and speed of interventions. […] In summary, cytoadherence and sequestration of pRBCs in cerebral microvasculature initiate local endothelial injury and apoptosis, inflammation, BBB dysfunction, brain swelling, and intracranial hypertension.

• #29 NCS News

  https://currents.neurocriticalcare.org/NCS-News/Article/getting-ready-to-celebrate-world-coma-day

  The Curing Coma Campaign (CCC), a crucial enterprise of the Neurocritical Care Society (NCS), was launched at the NCS 17th Annual Meeting in Vancouver B.C. with a vision to create a world where patients in coma are treated early and recover. […] One of the key aims of the CCC is the world-wide promotion of coma awareness by bringing together diverse stakeholders including patients, families, clinicians, scientists, educators, sponsors, philanthropists and interested individuals. […] World Coma Day is an international annual public event that will serve as a pivotal platform to bring about global awareness of the existing and novel science, education and patient care aspects of coma and disorders of consciousness (DoC). […] The inaugural World Coma Day will be held on March 22, 2021. It is programmed to be a 24-hour international online event featuring stories of remarkable recovery, science talks by world class experts, educational sessions for clinicians, patients and families, shout-outs from hospitals and rehabilitation units around the world and the announcement of the results of the COME TOGETHER global survey of health care providers to understand the spectrum of variability in coma epidemiology, evaluation and treatment practices across the world.

• #30 NCS News

  https://currents.neurocriticalcare.org/NCS-News/Article/world-coma-day-2021-wrap-up

  The intent of the COMa EpidemioloGy, Evaluation and THERapy (COME-toGETHER) survey was to investigate and understand the clinical spectrum of coma including the definition, diagnostic tools, treatment modalities, and prognostic factors. […] The results of this comprehensive global survey highlighted the worldwide variability in our current understanding and practice related to coma and has set the groundwork to identify key areas of future coma research in areas of therapeutic strategies, prognostic trajectories and pathobiological mechanisms. […] The existing worldwide variation in clinical practices related to disorders of consciousness and the acute need to advance coma science emerged as a resounding theme across multiple sessions and moderated discussions.

• #31 Epidemiology and prognosis of coma in daytime television dramas | The BMJ

  https://www.bmj.com/content/331/7531/1537

  Objective To determine how soap operas portray, and possibly misrepresent, the likelihood of recovery for patients in coma. […] Results Comas lasted a median of 13 days (interquartile range 7-25 days). Fifty seven (89%) patients recovered fully, five (8%) died, and two (3%) remained in a vegetative state. Mortality for non-traumatic and traumatic coma was significantly lower than would be predicted from the meta-analysis data (non-traumatic 4% v 53%; traumatic 6% v 67%; Fisher’s exact test both P 0.001). […] Conclusions The portrayal of coma in soap operas is overly optimistic. Although these programmes are presented as fiction, they may contribute to unrealistic expectations of recovery. […] Patients in soap operas who experience coma after traumatic or non-traumatic injury have a better than expected chance of survival. Moreover, they are very likely to regain full function.

• #32 Epidemiology and prognosis of coma in daytime television dramas | The BMJ

  https://www.bmj.com/content/331/7531/1537

  These findings show that soap operas portray an unrealistically optimistic version of the outcomes of patients in comas. Whether these programmes influence viewers’ beliefs about prognosis is not known, but television storylines are well known to carry substantial power to convince viewers. […] In the interests of public health, soap operas and other forms of mass media should seek to balance stories of improbable survival and recovery with compelling and compassionate stories of characters who die with comfort and dignity.

• #33 Ohio State researchers involved in first-of-its-kind global study on prevalence of coma | The Ohio State University College of Nursing

  https://nursing.osu.edu/news/2022/09/06/ohio-state-researchers-involved-first-its-kind-global-study-prevalence-coma

  Having this data at our disposal is critical not only in our understanding of the incidence of coma, but also in how we approach the condition at the bedside. […] The seriousness of coma requires us to gain a deeper understanding that can broaden our perspective for this and other disorders of consciousness. […] The study was sponsored by the Neurocritical Care Societys Curing Coma Campaign which, according to its website, is the first global public health initiative to tackle the unifying concept of coma as a treatable medical entity.

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