First Epidemiological Estimates of Coma Frequency Calculated in New Study
Coma Results from Many Different Brain Injuries and Medical Diseases
Coma is a medical and socioeconomic emergency but how common coma occurs after acute brain injury was previously unknown. In a new study published in Brain Communications, Stephan A. Mayer, M.D., professor of neurology and neurosurgery at New York Medical College (NYMC) and director of neurocritical care and emergency neurology services at Westchester Medical Center, along with researchers from the Curing Coma Campaign®, have now managed to calculate the very first epidemiological estimates of the frequency of coma.
The study, “Incidence and prevalence of coma in the UK and the USA: A citizen survey,” conducted by Dr. Mayer and 17 other neuroscientists from around the world utilized crowdsourcing methodology to determine how frequent coma is in the United States and United Kingdom.
"In contrast to neurological conditions for which epidemiological data are available, coma results from many different brain injuries or medical diseases. Coma is therefore not readily identifiable with conventional methods that utilize electronic medical records, insurance billing codes or clinical surveyance data", says Daniel Kondziella, a neurologist from Rigshospitalet, Copenhagen University Hospital, Denmark, who led the study.
According to Dr. Mayer, "Crowdsourcing methodology allows representative sampling of participants based on official census data, so the subjects we interviewed are an accurate subset of the larger general population. Family members are acutely aware of the impact of serious illnesses on their loved ones. This means that given a precise definition, family members can state with high confidence whether a relative has been in a coma within the preceding year or is in a coma at the time of inquiry. What we found is that the frequency of coma is comparable to other major conditions that we often encounter in intensive care, such as sepsis and traumatic brain injury, but until now we had no figures to demonstrate this.”
Interestingly, the authors identified many more cases of coma in the U.S. than in the UK. Dr. Mayer adds, “It’s important to understand that coma is largely a byproduct of modern medical technology. Without life support patients in coma will die quickly. The number of intensive care beds in the UK per capita is considerably lower than in the U.S. Although speculative, one contributing factor that might explain the higher incidence of coma in the U.S. versus the UK might be differences in how aggressively families pursue life support.”
No previous work has tried to provide such epidemiological data. Dr. Mayer concludes, "these figures are urgently needed because they broaden the public health perspective for patients in coma and other disorders of consciousness.”