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. 2022 Sep 1;4(5):fcac188.
doi: 10.1093/braincomms/fcac188. eCollection 2022.

Incidence and prevalence of coma in the UK and the USA

Daniel Kondziella  1   2 , Moshgan Amiri  1 , Marwan H Othman  1 , Ettore Beghi  3 , Yelena G Bodien  4   5 , Giuseppe Citerio  6   7 , Joseph T Giacino  4 , Stephan A Mayer  8 , Thomas N Lawson  9 , David K Menon  10 , Verena Rass  11 , Tarek Sharshar  12   13 , Robert D Stevens  14   15   16 , Lorenzo Tinti  3 , Paul Vespa  17   18 , Molly McNett  9 , Chethan P Venkatasubba Rao  19 , Raimund Helbok  11 ; Curing Coma Campaign Collaborators
Collaborators, Affiliations

Incidence and prevalence of coma in the UK and the USA

Daniel Kondziella et al. Brain Commun. .

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 n = 994, USA n = 977) provided data on 30 387 family members (UK n = 14 124, USA n = 16 263). 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 0.00-0.04%) 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.

Keywords: COVID-19; brain injury; cardiac arrest; coma; consciousness.

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Figures

Graphical abstract
Graphical abstract
Figure 1
Figure 1
Flowchart of the study survey. Flowchart of the study survey, including coma cases identified in first- and second-degree family members on the day of the survey or within the preceding year.
See this image and copyright information in PMC

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