Incidence and Prevalence of Coma in the UK and the USA

Authors

Daniel Kondziella, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
Moshgan Amiri, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
Marwan H. Othman, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
Ettore Beghi, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan 20156, Italy.
Yelena G. Bodien, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA 02115, USA.
Giuseppe Citerio, NeuroIntensive Care, ASST di Monza, Monza 20900, Italy.
Joseph T. Giacino, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA 02115, USA.
Stephan A. Mayer, Department of Neurology, New York Medical College, Valhalla, NY 10595, USA.Follow
Thomas N. Lawson, College of Nursing, The Ohio State University, Columbus, OH 43210, USA.
David K. Menon, Division of Anaesthesia, University of Cambridge, Cambridge CB2 2QQ, UK.Follow
Verena Rass, Department of Neurology, Neuro-Intensive Care Unit, Medical University of Innsbruck, Innsbruck 6020, Austria.
Tarek Sharshar, Neuro-anesthesiology and Intensive Care Medicine, Sainte-Anne Hospital, Paris-Descartes University, Paris 75006, France.
Robert D. Stevens, Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Lorenzo Tinti, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan 20156, Italy.
Paul Vespa, Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
Molly McNett, College of Nursing, The Ohio State University, Columbus, OH 43210, USA.
Chethan P. Venkatasubba Rao, Division of Vascular Neurology and Neurocritical Care, Baylor College of Medicine and CHI Baylor St Luke's Medical Center, Houston, TX 77030, USA.
Raimund Helbok, Department of Neurology, Neuro-Intensive Care Unit, Medical University of Innsbruck, Innsbruck 6020, Austria.

Author Type(s)

Faculty

DOI

10.1093/braincomms/fcac188

Journal Title

Brain Communications

First Page

fcac188

Document Type

Article

Publication Date

1-1-2022

Department

Neurology

Abstract

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 recruited UK and US laypeople (aged ≥18 years) who were nationally representative (i.e. matched for age, gender and ethnicity according to census data) of the UK and the USA, respectively, utilizing a crowdsourcing platform. We provided a description of coma and asked survey participants if they-'right now' or 'within the last year'-had a family member in coma. These participants (UK  = 994, USA  = 977) provided data on 30 387 family members (UK  = 14 124, USA  = 16 263). We found more coma cases in the USA ( = 47) than in the UK ( = 20;  = 0.009). We identified one coma case in the UK (0.007%, 95% confidence interval 0.00-0.04%) on the day of the survey and 19 new coma cases (0.13%, 95% confidence interval 0.08-0.21%) within the preceding year, resulting in an annual incidence of 135/100 000 (95% confidence interval 81-210) and a point prevalence of 7 cases per 100 000 population (95% confidence interval 0.18-39.44) in the UK. We identified five cases in the USA (0.031%, 95% confidence interval 0.01-0.07%) on the day of the survey and 42 new cases (0.26%, 95% confidence interval 0.19-0.35%) within the preceding year, resulting in an annual incidence of 258/100 000 (95% confidence interval 186-349) and a point prevalence of 31 cases per 100 000 population (95% confidence interval 9.98-71.73) in the USA. The five most common causes were stroke, medically induced coma, COVID-19, traumatic brain injury and cardiac arrest. 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.

Recommended Citation

Kondziella, D., Amiri, M., Othman, M. H., Beghi, E., Bodien, Y. G., Citerio, G., Giacino, J. T., Mayer, S. A., Lawson, T. N., Menon, D. K., Rass, V., Sharshar, T., Stevens, R. D., Tinti, L., Vespa, P., McNett, M., Venkatasubba Rao, C. P., & Helbok, R. (2022). Incidence and Prevalence of Coma in the UK and the USA. Brain Communications, 4 (5), fcac188. https://doi.org/10.1093/braincomms/fcac188