الفهرس 
ComaOnly 14 pages are availabe for public view
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Abstract
This work was carried out to evaluate the frequency of most common causes of metabolic coma in patients admitted to Tanta University Emergency Hospital.This study was carried out on 320 patients with metabolic cause of coma who were admitted to Tanta University Emergency Hospital over 2 years (from March 2017 till February 2019).All patients were subjected to full history taking from companions,full clinical examination, laboratory investigations including complete blood count (CBC), random serum glucose level, liver function tests (LFT), renal Function test (RFT), serum electrolytes level, blood Gases and coagulation profile. Specific investigations were done in indicated cases including ECG,HBA1C and hormonal assay. Radiological investigations performed in this study included plain X-ray chest, pelvi-abdominal ultrasonography and Computed Tomography (CT) brain as needed.We found that the most common cause of metabolic coma was hepatic encephalopathy (37.50%), followed by respiratory insufficiency (20.63%), renal cause of metabolic coma (17.81%) and finally hypoglycemic coma (15.00%). On the other hand, the least common causes of metabolic coma were endocrinal coma (1.25%), then Diabetic ketoacidosis (2.19%) and hyperosmolar non-ketotic state (5.63%).In the current study, the main predictors of mortality in all causes of metabolic coma were older age, rural residence, history of hepatic disease,recurrence of coma, low Glasgow coma score, late presentation to hospital since onset of coma, long hospital stay, low hemoglobin level, low platelet count, low serum albumin and high random blood sugar.In this study, total number of patients presented with different causes of metabolic coma was 161 and 159 in the first and second year respectively