Incidence, Etiology, and Clinical Outcomes of Acute Coma

Incidence, Etiology, and Clinical Outcomes of Acute Coma | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Incidence, Etiology, and Clinical Outcomes of Acute Coma Chih-Yuan Lin, Mingche Tsai, Jen-Feng Liang, Chih-Ching Liu, Yue-Chune Lee This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4697186/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objectives To investigate the clinical nature of acute coma, which will serve as a reference for subsequent clinical decision-making Methods and analysis This observational study utilized Taiwan National Health Insurance Database to identify cases of acute coma from 2000 to 2017 based on ED discharge diagnoses. Clinical Classification Software (CCS) was employed to categorize the causes of acute coma. We examined the characteristics of acute coma cases, age-specific incidence rates, underlying causes, and clinical outcomes such as reversible coma, hospitalization, and 30-day mortality. Additionally, we assessed functional outcomes at a one-year follow-up. Long-term factors influencing mortality were ascertained using Cox regression. Results Among 99,217,322 ED visits between 2000 and 2017, 419,480 acute coma events were identified, with an event rate of 4.23 per 1,000 ED visits and an incidence rate of 0.93 per 1,000 person-years. We analyzed 205,747 first-ever acute coma cases, predominantly male (58.90%), aged 58.27 years (SD 23.04). Infection and CNS causes were predominant. CNS and drug-related causes contributed to increased 30-day mortality, while psychiatric, alcohol, women's health and perinatal care, and seizure are causes linked to reversible coma. Patients needed intensive care (26.54%), life-sustaining treatments (41.09%), or disability (6.57%). Generalized estimating equations revealed that CNS (aOR, 0.68; 95% CI, 0.62 to 0.74; p < .0001) and drug-related causes (aOR, 0.72; 95% CI, 0.65 to 0.81; p < .0001) were less likely to result in reversible coma, suggesting higher 30-day mortality risk factors. Cox regression showed drugs (aHR, 1.30, 95% CI 1.20 to 1.41, p < .001), neoplasm (aHR, 1.18, 95% CI 1.11 to 1.25, p < .001), and symptoms (aHR, 1.44, 95% CI 1.24 to 1.67, p < .001) elevated the long-term death risk. Conclusion Our study demonstrates the use of ICD codes aggregation to CCS in acute coma clinical study, providing insights into its clinical nature. Coma Clinical Classifications Software Incidence Risk factors Natural history studies Prognosis Figures Figure 1 WHAT IS ALREADY KNOWN ON THIS TOPIC Acute coma with diverse causes and significant impacts on clinical course, mortality, and disability. Timely diagnosis and appropriate treatment are essential because acute coma often reflects life-threatening, systemic or intracranial processes. Heterogeneity results of acute coma studies may be due to research design and the underlying mechanism or cause are classified. Adopting secondary data for studying acute coma can provide valuable insight into preventing and treating acute coma. WHAT THIS STUDY ADDS Using the AHRQ Clinical Classification Software (CCS) method, we propose a new clinical research model for studying acute coma, addressing the research gap The incidence of acute coma is approximately 0.93 per 1,000 person-years, with older adults experiencing it at rates approximately 54 and 12 times higher than pediatric and adult groups, respectively. In the clinical course of acute coma, 45.49% of cases are reversible, 41.66% necessitate hospitalization, and within the 30-day mortality group, older adults constitute two-thirds. Infections and CNS-related diseases were the most common causes. The one-year follow-up after acute coma index date showed 26.54% of cases needed ICU treatment, 6.57% were complicated with a disability, and 1.88% were confined in nursing homes. INTRODUCTION Acute coma is a critical time-sensitive condition with heterogeneous causes that requires urgent attention and has significant impacts on patients and healthcare professionals 1 . It is characterized by profound failure of the neurological system responsible for maintaining arousal and awareness, leading to either a reflex response or no response to external stimuli at all 2 . Prior studies estimate that 1–5% of patients presenting to the emergency department (ED) have a disturbance in consciousness 3 4 . Emergency care researchers often categorize acute coma into three etiological factors: primary CNS disease, severe medical conditions that affect the CNS secondarily, or functional such as psychogenic disorder 5 6 . The clinical course of acute coma has been classified into three main categories: reversible coma, where patients recover quickly after ED management and can be discharged without any functional deficits; mortality group consisting of patients who do not survive their coma event despite medical interventions; and hospitalization group, which includes patients requiring hospitalization that may need intensive care or life-sustaining treatments (LSTs), or complicated with long-term disabilities 7 8 . Major challenge in studying acute coma is its heterogeneous nature, with multiple contributing factors often present in a single patient. Variations in acute coma study results may arise due to differences in definitions, cause classifications, and follow-up periods 9 . These factors can affect outcomes and complicate direct comparisons between studies, underscoring the need for standardized methodologies 10 . Despite the urgent need for a better understanding clinical nature of acute coma, there is a lack of large-scale longitudinal studies that can comprehensively address the incidence, causes, clinical course, and outcomes of acute coma. The Agency for Healthcare Research and Quality (AHRQ) has developed the Clinical Classification Software (CCS) to provide a standardized method for classifying diagnosis codes into CCS categories based on clinical characteristics 11 12 . The CCS categories employ the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and Tenth Revision, Clinical Modification (ICD-10-CM) classification systems to aggregate large numbers of ICD diagnostic codes into 285 clinically meaningful categories, thereby making clinical research more feasible. Our study aims to ( 1 ) estimate acute coma incidence, ( 2 ) use the CCS to identify acute coma causes, and ( 3 ) investigate the clinical course and outcomes. MATERIALS AND METHODS Study design and setting In this observational study, we utilized Taiwan National Health Insurance Research Database (NHIRD) to examine ED visits between January 1, 2000, and December 31, 2017. The NHIRD, managed by the Ministry of Health and Welfare, offered a comprehensive dataset with information on demographics, comorbidities, hospitalization, functional status, and mortality. This study was conducted with the approval of the local ethics board and involved no direct patient interaction. We carried out a retrospective analysis of claims data, ensuring all personal identifiers were encrypted to uphold patient confidentiality. Acute coma participants definition Given the nature of this study, we utilized the NHIRD dataset to investigate acute coma incidences. However, it should be noted that the NHIRD dataset lacks specific indicators like the Glasgow Coma Scale (GCS) to represent coma status. Consequently, we relied on the judgment of emergency physicians in diagnosing acute coma instances, especially in cases where there was no explicit diagnosis but an indication of coma in the ED's diagnoses. We employed International Classification of Diseases (ICD) codes to define acute coma objectively. These codes encompass a range of acute coma conditions, including "780.01" for comatose, "780.09" for other alterations of consciousness, "R40.0" for somnolence, "R40.1" for stupor, "R40.2" for unspecified coma, and "S06.7" for intracranial injury-related coma. Therefore, our study population consisted of cases that included any of these codes within the three diagnoses upon ED discharge records and remained as the final research cohort (Fig. 1 ). The present study implemented several exclusion criteria to ensure precise estimation of the cause, disease progression, and clinical outcomes associated with acute coma. First, we omitted cases lacking comprehensive sociodemographic data. Second, we excluded those who were undergoing life-sustaining treatments or were disabled or residing in a nursing home prior to the acute coma event. Additionally, cases diagnosed with acute coma in the ED that CCS could not further classify were removed from the study. To rule out hospitalizations potentially unrelated to the acute coma events, we excluded samples hospitalized more than 14 days following the acute coma. Incidence estimates We estimated the annual acute coma event rate from 2000 to 2017, with acute coma events as the unit of analysis. The event rate of acute coma is calculated by dividing the number of events by ED visits. In addition, we determined crude age group-stratified incidence rates were determined per 1000 person-years, with denominators based on the number of insured individuals during the year, taking into account their survival status and the person-years they contributed within that year. Considering insured individuals' survival status and person-years contributed and reported age-specific incidence rates in pediatric ( 1 – 18 ), adult (19–64), and senior adult (65+) groups with corresponding summary statistics. Clinical course, causes and outcomes assessment The study explored the clinical course of acute coma using each patient's first-ever event as the unit of analysis. Index date was set as the date of first diagnosis acute coma. ED visits were categorized into reversible coma, hospitalization, and 30-day mortality 13 . Individuals who died within 30 days of the acute coma ED index date were classified as the 30-day mortality group. Those requiring hospitalization within seven days post-episode but not dying within 30 days constituted the hospitalization group. Patients diagnosed with acute coma in the ED without needing hospitalization or facing death were categorized as the reversible coma group. Using CCS methodology 12 14 15 , we categorized ICD codes from death or hospitalization into 23 acute coma causes (Supplementary Table 1) and a statistical analysis plan is available in the (Supplementary Program). The diagnosis sequence began with death, hospitalization, and ED diagnosis if no death or hospitalization occured. These causes were further classified into three etiological mechanisms : ( 1 ) primary CNS diseases (neurological etiology), ( 2 ) medical conditions affecting the CNS secondarily (medical etiology), and ( 3 ) functional etiology 5 . Neurological etiology included acute CNS insult, chronic neurodegenerative encephalopathy, paroxysmal seizure disorders, and brain trauma. Medical etiology included alcohol-related coma, drugs, and organ system dysfunction. Functional factors included psychogenic disorders, symptoms, syncope, and other related causes. Patients were followed for one year to evaluate short-term outcome (30-day mortality or reversible course) and long-term outcomes (ICU admission, LSTs 16 , rehabilitation, disability status, or nursing home residency). Statistical analysis We used χ² tests to analyze baseline categorical characteristics and compared continuous variables' mean among coma groups with One-Way ANOVA. Generalized estimating equations (GEE ) were used to estimate the adjusted odds ratio (aOR) of acute coma, accounting for multiple causes and covariates like sex, age, CCI, occupation, urbanization, and income. Survival analysis was conducted for reversible and hospitalization groups, tracking survival probability and calculating time to event (death) or censoring. Cox regression investigated potential death event causes, with hazard ratios identifying factors affecting long-term outcomes. Analyses were performed with SAS software, version 9.4, and a significance level of p < 0.05. RESULTS Cohort characteristics and clinical course estimate Among 99,217,322 ED visits between 2000 and 2017, 419,480 acute coma events were identified. Of these, 365,675 patients were discharged or hospitalized within seven days. After excluding 4,385 ED visits with only acute coma diagnosis code, lacking further information, and participants lacking sociodemographic data or with prior nursing home or disabled status, 205,747 cases remained in the final research cohort (Fig. 1 ). The cohort clinical course classified 93,598 (45.49%) as reversible acute coma group, 85,712 (41.66%) as hospitalization group, and 26,437 (12.85%) as 30-day mortality group. The study population was 54.39% male, with an average age of 58.27 (SD 23.04) years (Table 1 ). Table 1 Characteristics of acute coma cohort Total acute coma n (%) Reversible coma n (%) Hospitalization n (%) 30-day mortality n (%) p -value Total 205,747 (100·00) 93,598 (45·49) 85,712 (41·66) 26,437 (12·85) < 0·001 Sex Male 111,897 (54·39) 49,738 (53·14) 46,910 (54·73) 15,249 (57·68) < 0·001 Female 93,850 (45·61) 43,860 (46·86) 38,802 (45·27) 11,188 (42·32) Age 58·27 ± 23·04 39·81 ± 19·99 52·93 ± 22·93 70·99 ± 16·90 < 0·001 Age group < 18 61,756 (30·02) 38,509 (13·56) 19,661 (22·94) 3,586 (13·56) < 0·001 18–64 49,039 (23·83) 22,955 (23·88) 19,771 (23·07) 6,313 (23·88) ≧ 65 94,952 (46·15) 32,134 (62·56) 46,280 (53·99) 16,538 (62·56) CCI index CCI ≦ 1 133,867 (65·06) 73,552 (78·58) 46,694 (54·48) 13,621 (51·52) 1 71,880 (34·94) 20,046 (21·42) 39,018 (45·52) 12,816 (48·48) Income Low 58,488 (28·43) 26,255 (28·05) 25,054 (29·23) 7,179 (27·15) < 0·001 Middle 73,869 (35·90) 35,899 (38·35) 29,228 (34·10) 8,742 (33·07) High 73,390 (35·67) 31,444 (33·60) 31,430 (36·67) 10,516 (39·78) Occupation Dependents of the insured individuals 62,271 (30·27) 27,616 (29·50) 26,700 (31·15) 7,955 (30·09) < 0·001 Civil servants, teachers, military, veterans 2,915 (1·42) 1,429 (1·53) 1,151 (1·34) 335 (1·27) Nonmanual workers and professionals 20,121 (9·78) 11,891 (12·70) 6,401 (7·47) 1,829 (6·92) Manual workers 72,036 (35·01) 29,707 (31·74) 31,824 (37·13) 10,505 (39·73) Other 48,404 (23·53) 22,955 (24·53) 19,636 (22·91) 5,813 (21·99) Urbanization Urban 83,476 (40·57) 41,892 (44·76) 31,882 (37·20) 9,702 (36·70) < 0·001 Suburban 76,632 (37·25) 33,150 (35·42) 33,456 (39·03) 10,026 (37·92) Rural 45,639 (22·18) 18,556 (19·82) 20,374 (23·77) 6,709 (25·38) Causes of acute coma < 0·001 Neurological cause group 56,790 (27·60) 22,153 (23·67) 24,430 (28·50) 10,207 (38·61) < 0·001 CNS 30,065 (14·61) 8,183 (8·74) 14,639 (17·08) 7,243 (27·40) Encephalopathy 6,700 (3·26) 2,616 (2·79) 3,573 (4·17) 511 (1·93) Seizure 2,225 (1·08) 1,157 (1·24) 1,020 (1·19) 48 (0·18) Trauma 17,800 (8·65) 10,197 (10·89) 5,198 (6·06) 2,405 (9·10) Medical cause group 137,330 (66·75) 65,158 (69·61) 57,007 (66·51) 15,165 (57·36) Alcohol 2,533 (1·23) 2,255 (2·41) 257 (0·30) 21 (0·08) Cardiovascular 19,367 (9·41) 7,938 (8·48) 8,148 (9·51) 3,281 (12·41) Diabetes and insulin 11,155 (5·42) 4,178 (4·46) 5,529 (6·45) 1,448 (5·48) Digestive 19,904 (9·67) 9,364 (10·00) 7,968 (9·30) 2,572 (9·73) Drugs 5,036 (2·45) 2,002 (2·14) 1,941 (2·26) 1,093 (4·13) Electrolyte 456 (0·22) 249 (0·27) 152 (0·18) 55 (0·21) Endocrine 2,427 (1·18) 1,086 (1·16) 904 (1·05) 437 (1·65) Genitourinary 3,463 (1·68) 1,836 (1·96) 1,327 (1·55) 300 (1·13) Hematology 587 (0·29) 292 (0·31) 228 (0·27) 67 (0·25) Infection 31,063 (15·10) 14,714 (15·72) 14,005 (16·34) 2,344 (8·87) Musculoskeletal and integumentary 6,144 (2·99) 3,659 (3·91) 2,208 (2·58) 277 (1·05) Neoplasm 10,062 (4·89) 3,938 (4·21) 4,459 (5·20) 1,665 (6·30) Renal 3,564 (1·73) 1,149 (1·23) 1,884 (2·20) 531 (2·01) Respiratory 9,419 (4·58) 3,550 (3·79) 5,007 (5·84) 862 (3·26) Women's health and perinatal care 12,150 (5·91) 8,948 (9·56) 2,990 (3·49) 212 (0·80) Functional cause group 11,627 (5·65) 6,287 (6·72) 4,275 (4·99) 1,065 (4·03) Psychiatry 4,765 (2·32) 2,923 (3·12) 1,827 (2·13) 15 (0·06) Symptoms 1,379 (0·67) 881 (0·94) 342 (0·40) 156 (0·59) Syncope 521 (0·25) 352 (0·38) 169 (0·20) 0 (0·00) Others 4,962 (2·41) 2,131 (2·28) 1,937 (2·26) 894 (3·38) Outcome ICU 54,614 (26·54) 0 (0·00) 39,144 (45·67) 15,470 (58·52) < 0·001 LSTs 84,538 (41·09) 10,578 (11·30) 50,056 (58·40) 23,904 (90·42) < 0·001 Rehab 29,273 (14·23) 4,816 (5·15) 23,728 (27·68) 729 (2·76) < 0·001 Nursing home 3,861 (1·88) 492 (0·53) 3,261 (3·80) 108 (0·41) < 0·001 Disable 13,514 (6·57) 2,856 (3·05) 10,629 (12·40) 29 (0·11) < 0·001 CCI: Charlson Comorbidity Index; CI: confidence interval; CNS: central nervous system; ED: emergency department; ICU: intensive care units; LST: life-sustaining treatment; Chi-Square Test analyzed category variables distribution among groups; continue variable by One-way ANOVA· Incidence of acute coma Table 2 analyzes ICD diagnosis codes for acute coma events, revealing: ( 1 ) a crude event rate of 4.23 per 1,000 ED visits, ( 2 ) an average incidence rate of 0.93 per 1,000 person-years, and ( 3 ) age-specific incidence rates: 0.13 for pediatric, 0.57 for middle-aged, and 7.13 for senior adult groups. A significant mean decrease in incidence rate in 2016 suggests that age and temporal factors may influence acute coma incidence. Table 2 Acute coma event rate and incidence by year and age group Year ED visits Coma events Coma rate (‰) Incidence (‰) (95% CI) Age 1–18 Incidence (‰) (95% CI) Age 19–64 Incidence (‰) (95% CI) Age ≧ 65 Incidence (‰) (95% CI) 2000 4,519,482 10,330 2·29 0·45 (0·44 − 0·46) 0·08 (0·08 − 0·09) 0·30 (0·30 − 0·31) 7·74 (7·53 − 7·95) 2001 4,707,002 11,480 2·44 0·49 (0·48 − 0·50) 0·09 (0·08 − 0·10) 0·32 (0·32 − 0·33) 7·77 (7·57 − 7·97) 2002 5,028,446 12,567 2·50 0·53 (0·52 − 0·54) 0·10 (0·09 − 0·11) 0·34 (0·33 − 0·34) 7·78 (7·59 − 7·97) 2003 4,776,136 13,246 2·77 0·56 (0·55 − 0·57) 0·10 (0·09 − 0·10) 0·36 (0·35 − 0·36) 7·21 (7·04–7·38) 2004 5,354,185 16,072 3·00 0·67 (0·66 − 0·68) 0·11 (0·10 − 0·11) 0·44 (0·43 − 0·45) 7·58 (7·41 − 7·74) 2005 5,416,581 20,535 3·79 0·85 (0·83 − 0·86) 0·12 (0·11 − 0·13) 0·56 (0·54 − 0·57) 8·80 (8·63 − 8·97) 2006 5,171,689 21,769 4·21 0·89 (0·88 − 0·90) 0·13 (0·12 − 0·13) 0·57 (0·56 − 0·58) 8·59 (8·43 − 8·75) 2007 5,282,870 23,591 4·47 0·96 (0·94 − 0·97) 0·13 (0·12 − 0·14) 0·58 (0·57 − 0·60) 8·74 (8·59 − 8·89) 2008 5,191,529 25,548 4·92 1·02 (1·01–1·04) 0·14 (0·13 − 0·15) 0·63 (0·62 − 0·64) 8·53 (8·39 − 8·67) 2009 5,770,750 27,062 4·69 1·08 (1·07 − 1·09) 0·15 (0·14 − 0·16) 0·65 (0·64 − 0·67) 8·43 (8·30 − 8·57) 2010 5,878,033 31,184 5·31 1·23 (1·22 − 1·25) 0·17 (0·16 − 0·18) 0·73 (0·71 − 0·74) 9·27 (9·13 − 9·41) 2011 6,060,366 33,944 5·60 1·33 (1·32 − 1·35) 0·19 (0·18 − 0·20) 0·80 (0·78 − 0·81) 9·24 (9·11 − 9·37) 2012 6,098,194 34,259 5·62 1·33 (1·32 − 1·34) 0·19 (0·18 − 0·20) 0·79 (0·78 − 0·80) 8·60 (8·47 − 8·72) 2013 5,753,114 33,531 5·83 1·29 (1·28 − 1·31) 0·20 (0·19 − 0·21) 0·76 (0·75 − 0·77) 7·80 (7·69 − 7·91) 2014 5,904,262 34,917 5·91 1·34 (1·32 − 1·35) 0·19 (0·18 − 0·21) 0·78 (0·77 − 0·79) 7·48 (7·38 − 7·59) 2015 6,055,577 33,366 5·51 1·27 (1·25 − 1·28) 0·21 (0·19 − 0·22) 0·73 (0·72 − 0·74) 6·57 (6·47 − 6·66) 2016 6,303,662 19,355 3·07 0·73 (0·72 − 0·74) 0·09 (0·09 − 0·10) 0·39 (0·38 − 0·40) 3·70 (3·63 − 3·76) 2017 5,945,444 16,724 2·81 0·63 (0·62 − 0·64) 0·07 (0·07 − 0·08) 0·33 (0·32 − 0·34) 2·96 (2·90 − 3·02) Total Average 99,217,322 419,480 4·23 0·93 (0·93 − 0·94) 0·13 (0·13 − 0·13) 0·57 (0·57 − 0·57) 7·13 (7·10 − 7·16) CI: confidence interval; ED: emergency department; Coma rate(‰) = acute coma events/1,000ED visits Incidence of acute coma per 1,000 person-year Causes and outcomes of acute coma Table 1 presents leading acute coma causes, including infection (15.10%), CNS (14.61%), digestive (9.67%), cardiovascular (9.41%), and trauma-related (8.65%). Common reversible causes included infection (15.72%), trauma (10.89%), digestive (10.00%), women's health and perinatal care (9.56%), and CNS (8.74%). Hospitalization for acute coma frequently resulted from CNS (17.08%), infection (16.34%), cardiovascular (9.51%), digestive (9.30%), and diabetes and insulin (6.45%). Leading causes of death were CNS (27.40%), cardiovascular (12.41%), digestive (9.73%), trauma (9.10%), and infection (8.87%). Medical etiologies were the primary factor (66.75%), with neurological (27.60%) and functional (5.65%) etiologies also contributing. Short-term outcomes indicated 45.49% of cases left the ED without sequelae, 12.85% experienced 30-day mortality, and 41.66% necessitated hospitalization within seven days. Elderly patients had a significantly higher mortality rate of 62.56% compared to 11.56% for younger patients. The one-year follow-up showed ICU treatment (26.54%), LSTs (41.09%), rehabilitation (14.23%), disability (6.57%), and nursing care (1.88%). Multivariate analysis of acute coma The GEE analysis identified covariates significantly associated with increased acute coma mortality, including females, older age, higher Charlson Comorbidity Index (CCI) scores, low income, and rural residence (Table 3 ). Compared to other causes, CNS (adjusted odds ratio [aOR], 0.68; 95% CI: 0.62 to 0.74; p < .0001) and drug-related causes (aOR, 0.72; 95% CI: 0.65 to 0.81; p < .0001) had lower odds of reversible coma compared to 30-day mortality, while psychiatric (aOR, 57.02; 95% CI: 34.11 to 95.33; p < .0001), alcohol (aOR, 33.8; 95% CI: 21.81 to 52.38; p < .0001), women's health and perinatal care (aOR, 11.86; 95% CI: 10.11 to 13.92; p < .0001), seizures (aOR, 8.32; 95% CI: 6.15 to 11.24; p < .0001), and musculoskeletal/integumentary causes (aOR, 8.16; 95% CI: 7.04 to 9.47; p < .0001) had higher odds. Drug causes had lower odds of hospitalization compared to mortality (aOR, 0.82; 95% CI: 0.73 to 0.91; p = .0003), while psychiatry (aOR, 48.29; 95% CI: 28.88 to 80.77; p < .0001), seizure (aOR, 9.01; 95% CI: 6.67 to 12.17; p < .0001), women's health and perinatal care (aOR, 5.44; 95% CI: 4.63 to 6.40; p < .0001), and alcohol (aOR, 5.20; 95% CI: 3.31 to 8.17; p < .0001) causes increased the odds. Compared to functional etiology, neurological etiology had lower odds of reversible coma (aOR, 0.55; 95% CI, 0.51 to 0.59, p < .0001) and hospitalization (aOR, 0.70; 95% CI 0.65 to 0.75, p < .0001), while medical etiology had higher odds of reversible coma (aOR, 1.39; 95% CI: 1.30 to 1.49, p < .0001) and hospitalization (aOR, 1.16; 95% CI: 1.09 to 1.25, p < .0001). Table 3 Generalized linear model analysis of acute coma patients Reversible coma v.s. 30-day mortality Hospitalization v.s. 30-day mortality OR (95%CI) p -value aOR (95%CI) p -value OR (95%CI) p -value aOR (95%CI) p -value Sex Male vs Female 1·20 (1·17 − 1·23) < 0·0001 1·29 (1·25 − 1·33) < 0·0001 1·13 (1·10 − 1·16) < 0·0001 1·14 (1·10 − 1·17) < 0·0001 Age 19–64 vs ≤ 18 years old 0·34 (0·32 − 0·35) < 0·0001 0·44 (0·42 − 0·46) < 0·0001 0·57 (0·55 − 0·60) < 0·0001 0·59 (0·56 − 0·62) < 0·0001 ≥ 65 vs ≤ 18 years old 0·18 (0·17 − 0·19) < 0·0001 0·26 (0·25 − 0·27) < 0·0001 0·51 (0·49 − 0·53) < 0·0001 0·44 (0·42 − 0·46) 1 vs ≤ 1 0·29 (0·28 − 0·30) < 0·0001 0·44 (0·42 − 0·45) < 0·0001 0·89 (0·87 − 0·91) < 0·0001 1·04 (1·01–1·07) 0·0219 Income Middle vs low group 1·22 (1·18 − 1·26) < 0·0001 1·58 (1·52 − 1·64) < 0·0001 1·17 (1·13 − 1·21) < 0·0001 1·30 (1·25 − 1·35) < 0·0001 High vs low group 1·37 (1·33 − 1·42) < 0·0001 1·33 (1·28 − 1·37) < 0·0001 1·12 (1·08 − 1·16) < 0·0001 1·12 (1·09 − 1·17) < 0·0001 Occupation Dependents of the insured individuals vs others 0·82 (0·72 − 0·92) 0·0012 0·83 (0·73 − 0·95) 0·0055 0·98 (0·87 − 1·11) 0·7416 0·94 (0·83 − 1·07) 0·3469 Civil servants, teachers, military, veterans vs others 1·53 (1·34 − 1·74) < 0·0001 0·93 (0·81 − 1·07) 0·3002 1·02 (0·89 − 1·16) 0·774 0·84 (0·74 − 0·97) 0·0136 Nonmanual workers and professionals vs others 0·67 (0·59 − 0·75) < 0·0001 0·84 (0·74 − 0·96) 0·0084 0·88 (0·78 − 1·00) 0·0503 0·89 (0·78 − 1·01) 0·0799 Manual workers vs others 0·93 (0·82 − 1·05) 0·2501 1·04 (0·91 − 1·18) 0·6073 0·99 (0·87 − 1·12) 0·8258 1·01 (0·89 − 1·15) 0·8776 Urbanization Urban 0·77 (0·74 − 0·79) < 0·0001 0·83 (0·80 − 0·86) < 0·0001 1·02 (0·98 − 1·05) 0·3561 1·05 (1·01–1·08) 0·0064 Urbanization 0·64 (0·62 − 0·66) < 0·0001 0·77 (0·74 − 0·80) < 0·0001 0·92 (0·89 − 0·96) < 0·0001 0·98 (0·94 − 1·02) 0·2124 Causes of coma Neurological group 0·37 (0·34 − 0·39) < 0·0001 0·55 (0·51 − 0·59) < 0·0001 0·60 (0·56 − 0·64) < 0·0001 0·70 (0·65 − 0·75) < 0·0001 CNS 0·47 (0·44 − 0·52) < 0·0001 0·68 (0·62 − 0·74) < 0·0001 0·93 (0·86 − 1·02) 0·1051 1·09 (1·00–1·19) 0·0517 Encephalopathy 2·15 (1·90 − 2·43) < 0·0001 4·08 (3·59 − 4·63) < 0·0001 3·23 (2·86 − 3·65) < 0·0001 4·24 (3·75 − 4·80) < 0·0001 Seizure 10·11 (7·50 − 13·64) < 0·0001 8·32 (6·15 − 11·24) < 0·0001 9·81 (7·27 − 13·24) < 0·0001 9·01 (6·67 − 12·17) < 0·0001 Trauma 1·78 (1·63 − 1·95) < 0·0001 1·75 (1·59 − 1·92) < 0·0001 1·00 (0·91 − 1·10) 0·9585 1·02 (0·92 − 1·11) 0·7595 Medical group 0·73 (0·68 − 0·78) < 0·0001 1·39 (1·30 − 1·49) < 0·0001 0·94 (0·87 − 1·00) 0·0641 1·16 (1·09 − 1·25) < 0·0001 Alcohol 45·05 (29·11–69·72) < 0·0001 33·8 (21·81 − 52·38) < 0·0001 5·65 (3·60 − 8·88) < 0·0001 5·20 (3·31 − 8·17) < 0·0001 Cardiovascular 1·02 (0·93 − 1·11) 0·7406 2·04 (1·86 − 2·24) < 0·0001 1·15 (1·05 − 1·25) 0·0027 1·50 (1·37 − 1·65) < 0·0001 Diabetes and insulin 1·21 (1·10 − 1·34) 0·0001 3·13 (2·82 − 3·47) < 0·0001 1·76 (1·60 − 1·94) < 0·0001 2·31 (2·09 − 2·55) < 0·0001 Digestive 1·53 (1·40 − 1·67) < 0·0001 2·53 (2·31 − 2·78) < 0·0001 1·43 (1·31 − 1·57) < 0·0001 1·69 (1·54 − 1·85) < 0·0001 Drugs 0·77 (0·69 − 0·86) < 0·0001 0·72 (0·65 − 0·81) < 0·0001 0·82 (0·74 − 0·91) 0·0003 0·82 (0·73 − 0·91) 0·0003 Electrolyte 1·90 (1·40 − 2·57) < 0·0001 2·96 (2·17 − 4·04) < 0·0001 1·28 (0·93 − 1·75) 0·1342 1·53 (1·11 − 2·11) 0·0091 Endocrine 1·04 (0·91 − 1·19) 0·5473 1·49 (1·29 − 1·72) < 0·0001 0·96 (0·83 − 1·10) 0·5139 1·15 (1·00–1·32) 0·0521 Genitourinary 2·57 (2·22 − 2·97) < 0·0001 4·41 (3·80 − 5·12) < 0·0001 2·04 (1·76 − 2·37) < 0·0001 2·59 (2·23 − 3·01) < 0·0001 Hematology 1·83 (1·39 − 2·41) < 0·0001 2·53 (1·90 − 3·36) < 0·0001 1·57 (1·18 − 2·09) 0·0018 1·83 (1·38 − 2·44) < 0·0001 Infection 2·63 (2·41 − 2·88) < 0·0001 4·26 (3·88 − 4·67) < 0·0001 2·76 (2·52 − 3·02) < 0·0001 3·36 (3·07 − 3·69) < 0·0001 Musculoskeletal and integumentary 5·54 (4·79 − 6·41) < 0·0001 8·16 (7·04–9·47) < 0·0001 3·68 (3·17 − 4·27) < 0·0001 4·35 (3·75 − 5·05) < 0·0001 Neoplasm 0·99 (0·90 − 1·09) 0·8747 2·06 (1·86 − 2·28) < 0·0001 1·24 (1·12 − 1·36) < 0·0001 1·57 (1·42 − 1·73) < 0·0001 Renal 0·91 (0·80 − 1·03) 0·142 2·30 (2·01–2·62) < 0·0001 1·64 (1·45 − 1·86) < 0·0001 2·21 (1·95 − 2·51) < 0·0001 Respiratory 1·73 (1·55 − 1·93) < 0·0001 3·54 (3·16 − 3·96) < 0·0001 2·68 (2·41 − 2·98) < 0·0001 3·57 (3·20 − 3·98) < 0·0001 Women's health and perinatal care 17·71 (15·13–20·72) < 0·0001 11·86 (10·11–13·92) < 0·0001 6·51 (5·55 − 7·64) < 0·0001 5·44 (4·63 − 6·40) < 0·0001 Functional group (ref· of coma group) Psychiatry 81·68 (48·90–136·46) < 0·0001 57·02 (34·11–95·33) < 0·0001 56·17 (33·59–93·92) < 0·0001 48·29 (28·88 − 80·77) < 0·0001 Symptoms 2·37 (1·97 − 2·86) < 0·0001 2·78 (2·30 − 3·38) < 0·0001 1·01 (0·82 − 1·24) 0·9106 1·11 (0·90 − 1·37) 0·3158 Syncope NC NC NC NC Others (ref of causes of coma) aOR: adjusted odds ratio; CCI: Charlson Comorbidity Index; CI: confidence interval; CNS: central nervous system; ED: emergency department; ICU: intensive care units; LST: life-sustaining treatment; Syncope: no convergence The Kaplan-Meier estimation (Supplementary Fig. 1) and Cox proportional hazards regression (Table 4 ) revealed increased mortality risk associated with higher CCI score (adjusted hazard ratios [aHR], 1.08, 95% CI 1.07 to 1.09, p < .001), older age (aHR, 2.17, 95% CI 2.13 to 2.22, p < .001), manual labor (aHR, 1.03, 95% CI 1.02 to 1.04, p < .001), drug (aHR, 1.30, 95% CI 1.20 to 1.41, p < .001), neoplasm (aHR, 1.18, 95% CI 1.11 to 1.25, p < .001), and symptoms cause (aHR, 1.44, 95% CI 1.24 to 1.67, p < .001). In addition, the average mortality post-acute coma for the reversible group was observed at 7.10 years, while for the hospitalization group, it occurred at 6.41 years. Table 4 Multivariate Cox regression analysis of factors contributing to all-cause mortality in acute coma patients Cox proportional hazards aHR p -value Sex (male) 0·82 (0·80 − 0·84) 1) 1·08 (1·07 − 1·09) < 0·001 Age (old age) 2·17 (2·13–2·22) < 0·001 Income (high) 0·98 (0·97 − 1·00) 0·05 Occupation (manual) 1·03 (1·02 − 1·04) < 0·001 Area (urban) 1·02 (1·01–1·04) 0·01 Neurological group CNS 0·83 (0·79 − 0·88) < 0·001 Encephalopathy 0·93 (0·87 − 0·99) 0·04 Seizure 0·32 (0·26 − 0·39) < 0·001 Trauma 0·48 (0·45 − 0·52) < 0·001 Medical group Alcohol 0·39 (0·30–0·51) < 0·001 Cardiovascular 0·94 (0·89 − 0·99) 0·02 Digestive 0·91 (0·86 − 0·96) < 0·001 Drugs 1·30 (1·20 − 1·41) < 0·001 Electrolyte 0·99 (0·78 − 1·25) 0·93 Endocrine 0·76 (0·67 − 0·86) < 0·001 Genitourinary 0·43 (0·38–0·49) < 0·001 Hematology 0·63 (0·49 − 0·80) < 0·001 Infection 0·66 (0·63 − 0·69) < 0·001 Musculoskeletal and integumentary 0·31 (0·28 − 0·35) < 0·001 Neoplasm 1·18 (1·11 − 1·25) < 0·001 Renal 1·05 (0·97 − 1·13) 0·21 Respiratory 0·80 (0·75 − 0·85) < 0·001 Women's health and perinatal care 0·15 (0·13 − 0·18) < 0·001 Functional group Psychiatry 0·05 (0·03 − 0·05) < 0·001 Symptoms 1·44 (1·24–1·67) < 0·001 Syncope 0·00 · Others 0·47 (0·42 − 0·53) 1 group), Income (high-income group), Area (urban), Occupation (manual), Sex (male) Syncope: no convergence Sensitivity test of acute coma To assess the robustness of our findings, we focused on the definition of an acute coma cohort, explicitly examining the first-ever episode that led to hospitalization within either a 7-day or 14-day period. Our analysis revealed no significant differences between these two cohort definitions in terms of clinical course subgroup distribution and cause classification for acute coma (see Supplementary Table 2). This suggests that our findings are consistent and reliable across different definitions. DISCUSSION Acute coma frequently represents a common pathway of organ dysfunction from diverse causes, significantly impacting patients' survival and quality of life and straining healthcare resources. This study aims to explore the incidence density, causes, clinical courses, and outcomes of acute coma. Several methodological and result issues warrant discussion. Methodology discussion In our 18-year longitudinal retrospective cohort study, we utilize the ICD coding system alongside the CCS method to navigate the complex etiology of acute coma. This complexity, stemming from an array of reversible and time-sensitive factors, creates challenges in synthesizing diverse clinical causes into a unified cohort for claims-based research. Previous studies have often relied on medical record reviews 17 or rigorously designed cohort studies 18 , lacking a comprehensive and longitudinal perspective. To bridge this research gap, we have devised an innovative clinical research model that integrates big data analytics with clinical investigation. This approach offers a novel framework for examining the multifaceted clinical scenarios related to acute coma through claims-based data, thereby opening new avenues for neuroscientific research and enhancing emergency medical decision-making systems. Study design, population and cohort definition The Taiwan NHIRD, encompassing the entire population and offering comprehensive medical services, facilitated a thorough analysis of acute coma's clinical nature. Besides, The large cohort of over 200,000 patients offered a robust population representation. Moreover, we defined the cohort based on one impaired consciousness in the ED study, where the average hospitalization duration was 6.4 days. Thereforee we included acute coma onset and hospitalization within seven days as our study cohort 19 . By excluding patients with prior nursing home residence or disability status, provids a better understanding of the true incidence and outcomes of first-ever acute coma. Meanwhile, the lack of clinical coma scale data raises concerns about the methodology accuracy, which relied on ICD coding and the CCS method. Our study adopted a broader definition of acute coma, using ICD codes, covering various alterations of consciousness such as somnolence, stupor, unspecified coma, and intracranial injury-related coma. Our study adopted a broad range of acute coma diagnosis codes to capture various clinical scenarios 20 . We used ICD coding methodology covering the qualitative spectrum of 'decreased consciousness,' including somnolence, stupor, coma, and quantitative GCS score ranges 20 . We also included the current quantitative approach to coma assessment, coding GCS scores of 13–15 as R40.0, 9–12 as R40.1, and ≤ 8 as R40.2. This approach ensured a thorough representation of acute coma in our research sample. Defined of acute coma cause Integrating CCS with the ICD coding system in clinical research potentially offers a holistic and nuanced methodology for categorizing complex clinical data into clinically meaningful classes 14 . While established frameworks for transforming a myriad of ICD codes into clinically relevant categories that can guide clinical decision-making, inform policy interventions, or enable regular monitoring are not yet widespread 12 , In our study, we utilized CCS to condense 285 CCS categories into 23 clinically relevant causes of acute coma, rendering the study practically feasible and enabling the in-depth analysis of acute coma's multifaceted clinical manifestations. This approach facilitates large-scale, longitudinal population-based studies in EDs, optimizing approaches to address acute coma's clinical nature. Results discussion Understanding the clinical characteristics of acute coma makes it crucial for intensivist clinicians to identify the cause to prevent disability 21 and emergency medical policy applications. Causes, clinical courses, and outcomes Infections, CNS disorders, digestive issues, cardiovascular events, and trauma are leading causes of acute coma. Our research results are consistent with international findings, with infection being the most common cause 22 23 . Acute coma causes differ based on geography 24 or age 22 . For instance, poisoning contributes to approximately one-third of unconsciousness cases in Nordic countries 24 . In children, common causes are intoxication, epilepsy, infection, and traumatic brain injury 17 . In adults and older adults, CNS and infectious disorders are more common 17 20 . The prominence of digestive causes for acute coma in our cohort may be due to the prevalence of hepatitis and hepatocellular carcinoma in Taiwan 25 . To facilitate a broader understanding of public health implications related to the potential etiologies and mechanisms underlying acute coma, and to enable meaningful comparisons with existing literature, we have classified the etiologies of acute coma into three major categories: neurological, medical, and functional factors 5 6 26 . This categorization approach aids in the development of targeted intervention strategies and informs policy-making. Neurological causes account for about one-third of cases, while non-neurological causes comprise the remaining two-thirds 27 . Schmidt (2017) reported that neurological and medical etiologies each contributed to about 50% of acute coma cases 5 . Functional or psychogenic coma constituted around 5% of cases. It is worth further exploring the causes of coma resulting from functional factors. The clinical course of acute coma varies due to differing underlying causes or etiologies 9 22 . Over half of first-ever acute coma patients required hospitalization or faced mortality, whereas the other near half demonstrated reversible outcomes. Short-term in-hospital mortality rate for patients with acute coma is about 5–11% 3 19 28 with longer follow-up reaching 25% 28 . Our study found that 27.60% of acute coma cases were attributed to neurological etiology, and within the mortality group, 38.16% of cases had a neurological cause. This supports prior research indicating that clinical course is highly dependent on etiology 22 . Syncope and seizures are generally believed to be the most common causes of reversible coma. However, in our study, these two common causes accounted for only 1.33% of cases of overall acute coma. This may support researchers' definition of coma as a state of prolonged sustained unconsciousness lasting at least one hour 29 . Our emergency physicians may better understand syncope and seizure, improving diagnostic accuracy 30 . Study showed that twenty percent of patients with acute coma may have already been reversible on admission 28 . If these patients are monitored for two months after hospitalization, one-third of them may fully recover consciousness 31 . Our study found that approximately 45.49% of patients had reversible coma. The higher proportion of reversible coma in our study may reflect a more lenient coding of coma or the higher quality of emergency medical care by emergency physicians in our study. These results suggest that the outcome of acute coma is highly dependent on the underlying cause and severity of the condition 32 . Regarding long-term outcomes, one-quarter of patients with first-ever acute coma necessitated ICU admission, and forty percent required LSTs within one year. The high percentage of patients in the LSTs group, who require long-term care and have a high mortality rate, emphasizes the need for improved management strategies for patients with acute coma 7 . Incidence Our study found an acute coma event rate of 4.23 visits per 1,000 ED visits, consistent with the Schmidt et al. (2019) ED cohort study 28 . However, our results differ from another study that reported 0.29–0.40 cases of coma per 1,000 ED visits 33 . Based on the ICD code approach, studies suggested that acute coma is about 0.93-5% of all ED visits 27 34 . Pediatric non-trauma coma studies also have reported incidences ranging from 0.3 to 1.6 per 1,000 person-years 22 . This disparity in results may be attributed to differences in research questions, study design, study population, or definitions 35 . We investigated the incidence rates of acute coma in different age groups and temporal trends. The highest incidence rate of acute coma was observed in the elderly age group, emphasizing the significance of this public health concern in the aging population. However, there is also some variability in the incidence rates over time. We found that the incidence rate stabilized at around 1 per 1,000 person-years from 2007 to 2015 and observed a significant mean decrease in the incidence rate in 2016 compared to previous years. Specifically, there was a significant mean decrease from 0.73 per 1,000 person-years in 2016 to 0.63 per 1,000 person-years in 2017. One possible explanation for the decrease in acute coma incidence during 2016–2017 is the transition from the ICD-9 to ICD-10 coding system in 2015. We also found that there was no significant difference in the number of ED visits between 2014 and 2017 (5,904,262 vs 5,945,444, respectively). Thus, the significant change in acute coma incidence could be an artifact of the ICD coding transition effect 36 . Strengths and Limitations This study has several strengths and limitations. Strengths include using nationwide longitudinal data to observe first-ever acute coma patterns, enabling tracking of clinical progression. The average post-acute coma mortality occurring seven years highlights its importance as a risk factor and common pathway for mortality. Additionally, the study employed AHRQ CCS methodology, facilitating regular monitoring of acute coma clinical information and enabling tailored intervention plans. The present study has several limitations that need to be acknowledged. Firstly, the absence of a coma scale to accurately define the first-ever acute coma cohort represents a significant limitation. Instead, the study relied on acute coma-related diagnoses coded by emergency physicians in the ED, potentially leading to an underestimation of acute coma incidence and compromising the accuracy of identifying the causes of coma. Additionally, the conversion between ICD-9 and ICD-10 coding systems may introduce inaccuracies in estimating coma-related diagnoses due to potential discrepancies and inconsistencies in classification. Consequently, the reliability of the results may be affected. Furthermore, it is important to recognize that the acute coma diagnosis employed in this study may not fully capture the underlying causes or medical utilization, as multiple contributing pathologies could be involved due to potential multiple underlying pathologies 28 . The complexity of coma etiology, along with the potential presence of various underlying factors, may limit the accuracy of attributing the diagnosis to a single cause. Moreover, a small proportion (about 2%) of acute coma patients presented in the ED lacked further diagnostic information, which reflects the challenge in diagnosing cases of coma with unknown origins and introduces potential uncertainty and incomplete data in the analysis. Another limitation is the reliance on data limited to the year 2017, preventing the examination of the potential effects of the COVID-19 pandemic. Incorporating the impact of the pandemic would have enhanced the understanding of the significance of infections and central nervous system-related causes in estimating acute coma incidence. Finally, it should be noted that this study did not utilize the World Health Organization's (WHO) World Standard Population for age-specific rates adjustment, which may limit the generalizability and comparability of the findings with other studies that utilize standardized rates based on the WHO standard populations. These limitations should be considered when interpreting the study's results, and future research should address these limitations to enhance the robustness and applicability of the findings. CONCLUSION Acute coma often represents a common pathway of organ dysfunction with diverse causes or etiologies, significantly impacting mortality and disability. Our study demonstrates the innovative use of ICD code aggregation to CCS in acute coma clinical study, providing valuable insights into its clinical nature. This research model has the potential to facilitate international comparative studies of acute coma characteristics using health databases. Declarations Ethics approval and consent to participate All authors have completed the ICMJE conflict of interest form and declare no conflicts of interest in relation to this manuscript. The study involved a retrospective analysis of encrypted unique personal identification data without direct patient involvement. Therefore, no patient consent was necessary for the completion of this study. As the corresponding author, I confirm that we complied with all applicable laws regarding data protection and privacy. No patients were involved. This study was a retrospective claim data analysis that included all encrypted unique personal identification. Ethics approval: IRB of Taipei City Hospital, number- TCHIRB-10807003-E. Consent for publication Not applicable. Patients or the public involvement: Patients or the public were not involved in the design, or conduct, or reporting, or dissemination plans of our research Availability of data and materials The data that support the findings of this study are available from Taiwan National Health Insurance Research Database but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the academic request and with permission of Taiwan National Health Insurance Administration. Competing interests The authors declare that they have no competing interests. Funding The authors declare that they have no funding. Confirm the use of reporting checklist (see below), if appropriate The authors have confirmed the use of reporting checklists. We adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement when reporting observational studies and the Standards of Reporting of Neurological Disorders (STROND) for reporting incidence studies in neuroepidemiology. Authors' contributors CY Lin took a lead role in conceptualizing the study and writing the original draft, and was responsible for formal data analysis. CY Lin and CC Liu verified the underlying data in the manuscript. MC Tsai contributed to study design, data curation, and formal data analysis, and was in charge of data collection. JF Liang and MC Tsai ensured accurate data analysis and interpretation, and verified the manuscript's underlying data. YC Lee supervised the study, validated the results, and significantly contributed to reviewing and editing the manuscript. All authors participated in developing the study concept and design, analysing and interpreting data, and preparing the manuscript. We have all approved the final manuscript and agree to be accountable for all aspects of the work, promising to appropriately investigate and resolve any question related to the work's accuracy or integrity. Acknowledgments We acknowledge the Taiwan National Health Insurance Research Database, which was provided by the National Health Insurance Administration, and is managed by National Health Research Institutes. We also thank the Center for Public Health, Department of Education and Research, Taipei City Hospital, for providing administrative and research grant support. 1) Confirm that manuscript complies with all instructions to authors The authors confirm that our manuscript adheres to all the instructions provided for authors. 2) Confirm that authorship requirements (see below) have been met and the final manuscript was approved by all authors All authors, coinvestigators, and contributors know and agree to the Authorship Policies outlined in the Author Center. 3) Confirm that this manuscript has not been published elsewhere and is not under consideration by another journal The authors confirm that this work is original, unpublished elsewhere and respectfully request its consideration for acceptance in the esteemed journal. 4) Confirm adherence to ethical guidelines and indicate ethical approvals (IRB) and use of informed consent, as appropriate (see below). Retrospective studies require a statement regarding IRB approval All authors have completed the ICMJE conflict of interest form and declare no conflicts of interest in relation to this manuscript. The study involved a retrospective analysis of encrypted unique personal identification data without direct patient involvement. Therefore, no patient consent was necessary for the completion of this study. As the corresponding author, I confirm that we complied with all applicable laws regarding data protection and privacy. No patients were involved. This study was a retrospective claim data analysis that included all encrypted unique personal identification. Ethics approval: IRB of Taipei City Hospital, number- TCHIRB-10807003-E. 5) Disclose Conflicts of Interest for all authors The authors report no disclosures relevant to the manuscript. 6) Confirm the use of reporting checklist (see below), if appropriate The authors have confirmed the use of reporting checklists. We adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement when reporting observational studies and the Standards of Reporting of Neurological Disorders (STROND) for reporting incidence studies in neuroepidemiology. 7) Source of funding for the study The research grant supported by Taipei City Hospital References Lutz M, Mockel M, Lindner T, et al. The accuracy of initial diagnoses in coma: an observational study in 835 patients with non-traumatic disorder of consciousness. Scand J Trauma Resusc Emerg Med 2021;29(1):15. doi: 10.1186/s13049-020-00822-w Samuels MA. A practical approach to coma diagnosis in the unresponsive patient. Cleve Clin J Med 1992;59(3):257-61. Xiao HY, Wang YX, Xu TD, et al. Evaluation and treatment of altered mental status patients in the emergency department: Life in the fast lane. World J Emerg Med 2012;3(4):270-7. doi: 10.5847/wjem.j.1920-8642.2012.04.006 Samborska-Sablik A, Gaszyński W, Gaszyński T, et al. Coma - The interdisciplinary problem. Polski Merkuriusz Lekarski 2005;18(108):703-08. Braun M, Ploner CJ, Lindner T, et al. [Coma in the emergency room]. Nervenarzt 2017;88(6):607-15. doi: 10.1007/s00115-017-0329-8 [published Online First: 2017/04/21] Stevens RD, Bhardwaj A. Approach to the comatose patient. Crit Care Med 2006;34(1):31-41. Wijdicks EFM. Predicting the outcome of a comatose patient at the bedside. Pract Neurol 2020;20(1):26-33. doi: 10.1136/practneurol-2019-002359 [published Online First: 2019/09/21] Haupt WF, Hansen HC, Janzen RW, et al. Coma and cerebral imaging. Springerplus 2015;4:180. doi: 10.1186/s40064-015-0869-y [published Online First: 2015/05/20] Helbok R, Rass V, Beghi E, et al. The Curing Coma Campaign International Survey on Coma Epidemiology, Evaluation, and Therapy (COME TOGETHER). Neurocrit Care 2022;37(1):47-59. doi: 10.1007/s12028-021-01425-8 [published Online First: 20220209] Horsting MW, Franken MD, Meulenbelt J, et al. The etiology and outcome of non-traumatic coma in critical care: a systematic review. BMC Anesthesiol 2015;15(1):1-8. Cost H, Project U. Clinical classifications software (CCS) for ICD-9-CM. Available at: www hcup-us ahrq gov/toolssoftware/ccs/ccs jsp Accessed February 2018;27 Salsabili M, Kiogou S, Adam TJ. The Evaluation of Clinical Classifications Software Using the National Inpatient Sample Database. AMIA Jt Summits Transl Sci Proc 2020;2020:542-51. [published Online First: 20200530] Srinivasan S, Bidkar PU. Approach to a Patient with Coma. Acute Neuro Care: Springer 2020:23-34. Quality AfHRa. Clinical Classifications Software (CCS) for ICD-9-CM and ICD-10: Agency for Healthcare Research and Quality; [Available from: https://www.hcup-us.ahrq.gov/toolssoftware/ccs/ccs.jsp accessed March, 20 2021. Chute CG. Clinical classification and terminology: some history and current observations. J Am Med Inform Assoc 2000;7(3):298-303. Lin C-Y, Lee Y-C. Choosing and Doing wisely: triage level I resuscitation a possible new field for starting palliative care and avoiding low-value care – a nationwide matched-pair retrospective cohort study in Taiwan. BMC Palliat Care 2020;19(1):87. doi: 10.1186/s12904-020-00590-5 Wong CP, Forsyth RJ, Kelly TP, et al. Incidence, aetiology, and outcome of non-traumatic coma: a population based study. Arch Dis Child 2001;84(3):193-9. doi: 10.1136/adc.84.3.193 Schmidt WU, Ploner CJ, Lutz M, et al. Causes of brain dysfunction in acute coma: a cohort study of 1027 patients in the emergency department. Scand J Trauma Resusc Emerg Med 2019;27(1):101. doi: 10.1186/s13049-019-0669-4 [published Online First: 2019/11/09] Volk S, Koedel U, Pfister HW, et al. Impaired Consciousness in the Emergency Department. Eur Neurol 2018;80(3-4):179-86. doi: 10.1159/000495363 Kekec Z, Senol V, Koc F, et al. Analysis of altered mental status in Turkey. Int J Neurosci 2008;118(5):609-17. doi: 10.1080/00207450701849133 [published Online First: 2008/05/01] Provencio JJ, Hemphill JC, Claassen J, et al. The Curing Coma Campaign: Framing Initial Scientific Challenges-Proceedings of the First Curing Coma Campaign Scientific Advisory Council Meeting. Neurocrit Care 2020;33(1):1-12. doi: 10.1007/s12028-020-01028-9 Wong C, Forsyth R, Kelly T, et al. Incidence, aetiology, and outcome of non-traumatic coma: a population based study. Arch Dis Child 2001;84(3):193-99. Seshia SS, Bingham WT, Kirkham FJ, et al. Nontraumatic coma in children and adolescents: diagnosis and management. Neurol Clin 2011;29(4):1007-43. doi: 10.1016/j.ncl.2011.07.011 Forsberg S, Höjer J, Enander C, et al. Coma and impaired consciousness in the emergency room: characteristics of poisoning versus other causes. Emerg Med J 2009;26(2):100-02. Kuo S-C, Lin C-N, Lin Y-J, et al. Optimal intervals of ultrasonography screening for early diagnosis of hepatocellular carcinoma in Taiwan. JAMA network open 2021;4(6):e2114680-e80. Braun M, Schmidt WU, Möckel M, et al. Coma of unknown origin in the emergency department: implementation of an in-house management routine. Scand J Trauma Resusc Emerg Med 2016;24:61. doi: 10.1186/s13049-016-0250-3 [published Online First: 2016/04/29] Xiao H-y, Wang Y-x, Teng-da Xu H-dZ, et al. Evaluation and treatment of altered mental status patients in the emergency department: Life in the fast lane. World J Emerg Med 2012;3(4):270. Schmidt WU, Ploner CJ, Lutz M, et al. Causes of brain dysfunction in acute coma: a cohort study of 1027 patients in the emergency department. Scand J Trauma Resusc Emerg Med 2019;27(1):101. doi: 10.1186/s13049-019-0669-4 Amorim RL, Nagumo MM, Paiva WS, et al. Current clinical approach to patients with disorders of consciousness. Rev Assoc Med Bras 2016;62(4):377-84. doi: 10.1590/1806-9282.62.04.377 Baron-Esquivias G, Martinez-Alday J, Martin A, et al. Epidemiological characteristics and diagnostic approach in patients admitted to the emergency room for transient loss of consciousness: Group for Syncope Study in the Emergency Room (GESINUR) study. Europace 2010;12(6):869-76. doi: 10.1093/europace/euq018 Lucca LF, Lofaro D, Pignolo L, et al. Outcome prediction in disorders of consciousness: the role of coma recovery scale revised. BMC Neurol 2019;19(1):68. doi: 10.1186/s12883-019-1293-7 [published Online First: 2019/04/20] Hamel MB, Goldman L, Teno J, et al. Identification of comatose patients at high risk for death or severe disability. JAMA 1995;273(23):1842-48. Skinner HG, Blanchard J, Elixhauser A. Trends in Emergency Department Visits, 2006–2011: Statistical Brief #179: Agency for Healthcare Research and Quality (US), Rockville (MD) 2006. Kanich W, Brady WJ, Huff JS, et al. Altered mental status: evaluation and etiology in the ED. The American journal of emergency medicine 2002;20(7):613-17. Skinner HG, Blanchard J, Elixhauser A. Trends in emergency department visits, 2006–2011: statistical brief# 179. 2014 Cai CX, Michalak SM, Stinnett SS, et al. Effect of ICD-9 to ICD-10 Transition on Accuracy of Codes for Stage of Diabetic Retinopathy and Related Complications: Results from the CODER Study. Ophthalmol Retina 2021;5(4):374-80. doi: 10.1016/j.oret.2020.08.004 [published Online First: 20200815] Additional Declarations No competing interests reported. Supplementary Files SupplementarySAPComaCCSprogramfinal.zip STROBEchecklistv4combined.docx STRONDChecklistReportingofNeurologicalDisorders.doc.docx SupplementaryFigure1Survivalanalysisofacutecomapatients.doc Supplementary Figure 1 Survival analysis of acute coma patients SupplementaryTable1Clinicalclassificationsoftware.doc Supplementary Table 1 Clinical classification software for grouping the causes of acute coma SupplementaryTable2acutecomahospitalization14days.doc Supplementary Table 2 Characteristics of acute coma hospitalization within 14 days cohort Supplementary statistical analysis plan SAS program using clinical classification software for grouping the cause of acute coma Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4697186","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":326295851,"identity":"9ec54d0d-11f3-4479-ba25-a6892ef2901c","order_by":0,"name":"Chih-Yuan Lin","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAvElEQVRIiWNgGAWjYFAC5oYDQEIOxDzwgDgtjGAtxmAtCcRqAVmVCCIZiNLCPyOx8XBhjnX6/LDDD4G22MnpNhDQInEjseHwzG3puRtvpxkAtSQbmx0goMVAAqiFd9vh3I2zE0BaDiRuI1ZLuuHs9A+kaUmQl84h0haJMw9BWtINN0jnFBxIMCDCL/ztyYc/826zlpefnb75w4cKOzmCWhgEEqAuBKs0IKQcbA3UUPkGYlSPglEwCkbBiAQApZ5KJfyQvxkAAAAASUVORK5CYII=","orcid":"","institution":"Taipei City Hospital Linsen Chinese Medicine Branch","correspondingAuthor":true,"prefix":"","firstName":"Chih-Yuan","middleName":"","lastName":"Lin","suffix":""},{"id":326295852,"identity":"a40ddb23-a217-4f2c-b3a5-1100a6477d23","order_by":1,"name":"Mingche Tsai","email":"","orcid":"","institution":"National Yang Ming Chiao Tung University","correspondingAuthor":false,"prefix":"","firstName":"Mingche","middleName":"","lastName":"Tsai","suffix":""},{"id":326295853,"identity":"3d1a0856-b672-4bde-97bf-1c2681c5e31f","order_by":2,"name":"Jen-Feng Liang","email":"","orcid":"","institution":"Taipei Veterans General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Jen-Feng","middleName":"","lastName":"Liang","suffix":""},{"id":326295854,"identity":"4e41300c-5de7-411b-8a76-d5cb12d1258f","order_by":3,"name":"Chih-Ching Liu","email":"","orcid":"","institution":"Asia University","correspondingAuthor":false,"prefix":"","firstName":"Chih-Ching","middleName":"","lastName":"Liu","suffix":""},{"id":326295855,"identity":"9a2bdb67-49f7-4bfe-9542-3efb83200cd6","order_by":4,"name":"Yue-Chune Lee","email":"","orcid":"","institution":"National Yang Ming Chiao Tung University","correspondingAuthor":false,"prefix":"","firstName":"Yue-Chune","middleName":"","lastName":"Lee","suffix":""}],"badges":[],"createdAt":"2024-07-06 14:22:27","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4697186/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4697186/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":62158307,"identity":"3eafbf2f-bba9-47b6-9409-95f4fa26f6a8","added_by":"auto","created_at":"2024-08-09 21:30:58","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":65468,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eFlow diagram of study\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4697186/v1/063683d055123fb17722e464.png"},{"id":69847293,"identity":"75181703-2ab6-4bc7-b903-3082a4b2ced9","added_by":"auto","created_at":"2024-11-25 20:31:39","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2538131,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4697186/v1/f39d939a-71df-4c10-a348-be0ae53ebd0d.pdf"},{"id":62159112,"identity":"0bc5d14e-65e0-43b6-b4df-3d7dc52bc938","added_by":"auto","created_at":"2024-08-09 21:38:58","extension":"zip","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":14286,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementarySAPComaCCSprogramfinal.zip","url":"https://assets-eu.researchsquare.com/files/rs-4697186/v1/bb31f460303bc5dd54ff2b91.zip"},{"id":62158310,"identity":"c14564fa-7e10-405d-83e8-a9f9763d5158","added_by":"auto","created_at":"2024-08-09 21:30:58","extension":"docx","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":34663,"visible":true,"origin":"","legend":"","description":"","filename":"STROBEchecklistv4combined.docx","url":"https://assets-eu.researchsquare.com/files/rs-4697186/v1/2a0c49cf72594f4c2d3ba846.docx"},{"id":62158309,"identity":"e28b3d21-9875-43cc-87a3-b15213bebebf","added_by":"auto","created_at":"2024-08-09 21:30:58","extension":"docx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":30234,"visible":true,"origin":"","legend":"","description":"","filename":"STRONDChecklistReportingofNeurologicalDisorders.doc.docx","url":"https://assets-eu.researchsquare.com/files/rs-4697186/v1/b24ca1098542033a0d05752f.docx"},{"id":62158311,"identity":"1296f725-1bee-4d98-bd66-76f828531e52","added_by":"auto","created_at":"2024-08-09 21:30:58","extension":"doc","order_by":5,"title":"","display":"","copyAsset":false,"role":"supplement","size":93184,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSupplementary Figure 1 Survival analysis of acute coma patients\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"SupplementaryFigure1Survivalanalysisofacutecomapatients.doc","url":"https://assets-eu.researchsquare.com/files/rs-4697186/v1/3fd5ae91f68aeabc9ac294cb.doc"},{"id":62158313,"identity":"7cab9084-fd75-424b-a5a5-5009ac819282","added_by":"auto","created_at":"2024-08-09 21:30:58","extension":"doc","order_by":6,"title":"","display":"","copyAsset":false,"role":"supplement","size":91136,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSupplementary Table 1 Clinical classification software for grouping the causes of acute coma\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"SupplementaryTable1Clinicalclassificationsoftware.doc","url":"https://assets-eu.researchsquare.com/files/rs-4697186/v1/c6dd4be3ce0a011af17c590f.doc"},{"id":62159113,"identity":"14e5fca8-f70c-4472-a714-8d16cd9e494c","added_by":"auto","created_at":"2024-08-09 21:38:58","extension":"doc","order_by":7,"title":"","display":"","copyAsset":false,"role":"supplement","size":130560,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSupplementary Table 2 Characteristics of acute coma hospitalization within 14 days cohort\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSupplementary statistical analysis plan SAS program using clinical classification software for grouping the cause of acute coma\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"SupplementaryTable2acutecomahospitalization14days.doc","url":"https://assets-eu.researchsquare.com/files/rs-4697186/v1/d7f65587036fd2638f8dcd9b.doc"}],"financialInterests":"No competing interests reported.","formattedTitle":"Incidence, Etiology, and Clinical Outcomes of Acute Coma","fulltext":[{"header":"WHAT IS ALREADY KNOWN ON THIS TOPIC","content":"\u003cul start=\"12\"\u003e\n \u003cli\u003e\u003cstrong\u003eAcute coma with diverse causes and significant impacts on clinical course, mortality, and disability.\u003c/strong\u003e\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eTimely diagnosis and appropriate treatment are essential because acute coma often reflects life-threatening, systemic or intracranial processes.\u003c/strong\u003e\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eHeterogeneity results of acute coma studies may be due to research design and the underlying mechanism or cause are classified.\u003c/strong\u003e\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eAdopting secondary data for studying acute coma can provide valuable insight into preventing and treating acute coma.\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"WHAT THIS STUDY ADDS","content":"\u003cul class=\"decimal_type\" start=\"12\"\u003e\n \u003cli\u003e\u003cstrong\u003eUsing the AHRQ Clinical Classification Software (CCS) method, we propose a new clinical research model for studying acute coma, addressing the research gap\u003c/strong\u003e\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eThe incidence of acute coma is approximately 0.93 per 1,000 person-years, with older adults experiencing it at rates approximately 54 and 12 times higher than pediatric and adult groups, respectively.\u003c/strong\u003e\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eIn the clinical course of acute coma, 45.49% of cases are reversible, 41.66% necessitate hospitalization, and within the 30-day mortality group, older adults constitute two-thirds.\u0026nbsp;\u003c/strong\u003e\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eInfections and CNS-related diseases were the most common causes.\u003c/strong\u003e\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eThe one-year follow-up after acute coma index date showed 26.54% of cases needed ICU treatment, \u0026nbsp;6.57% were complicated with a disability, \u0026nbsp;and 1.88% were confined in nursing homes.\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"INTRODUCTION","content":"\u003cp\u003eAcute coma is a critical time-sensitive condition with heterogeneous causes that requires urgent attention and has significant impacts on patients and healthcare professionals \u003csup\u003e1\u003c/sup\u003e. It is characterized by profound failure of the neurological system responsible for maintaining arousal and awareness, leading to either a reflex response or no response to external stimuli at all \u003csup\u003e2\u003c/sup\u003e. Prior studies estimate that 1\u0026ndash;5% of patients presenting to the emergency department (ED) have a disturbance in consciousness \u003csup\u003e3 4\u003c/sup\u003e. Emergency care researchers often categorize acute coma into three etiological factors: primary CNS disease, severe medical conditions that affect the CNS secondarily, or functional such as psychogenic disorder \u003csup\u003e5 6\u003c/sup\u003e. The clinical course of acute coma has been classified into three main categories: reversible coma, where patients recover quickly after ED management and can be discharged without any functional deficits; mortality group consisting of patients who do not survive their coma event despite medical interventions; and hospitalization group, which includes patients requiring hospitalization that may need intensive care or life-sustaining treatments (LSTs), or complicated with long-term disabilities \u003csup\u003e7 8\u003c/sup\u003e. Major challenge in studying acute coma is its heterogeneous nature, with multiple contributing factors often present in a single patient. Variations in acute coma study results may arise due to differences in definitions, cause classifications, and follow-up periods \u003csup\u003e9\u003c/sup\u003e. These factors can affect outcomes and complicate direct comparisons between studies, underscoring the need for standardized methodologies \u003csup\u003e10\u003c/sup\u003e. Despite the urgent need for a better understanding clinical nature of acute coma, there is a lack of large-scale longitudinal studies that can comprehensively address the incidence, causes, clinical course, and outcomes of acute coma.\u003c/p\u003e \u003cp\u003eThe Agency for Healthcare Research and Quality (AHRQ) has developed the Clinical Classification Software (CCS) to provide a standardized method for classifying diagnosis codes into CCS categories based on clinical characteristics \u003csup\u003e11 12\u003c/sup\u003e. The CCS categories employ the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and Tenth Revision, Clinical Modification (ICD-10-CM) classification systems to aggregate large numbers of ICD diagnostic codes into 285 clinically meaningful categories, thereby making clinical research more feasible. Our study aims to (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) estimate acute coma incidence, (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) use the CCS to identify acute coma causes, and (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) investigate the clinical course and outcomes.\u003c/p\u003e"},{"header":"MATERIALS AND METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and setting\u003c/h2\u003e \u003cp\u003eIn this observational study, we utilized Taiwan National Health Insurance Research Database (NHIRD) to examine ED visits between January 1, 2000, and December 31, 2017. The NHIRD, managed by the Ministry of Health and Welfare, offered a comprehensive dataset with information on demographics, comorbidities, hospitalization, functional status, and mortality. This study was conducted with the approval of the local ethics board and involved no direct patient interaction. We carried out a retrospective analysis of claims data, ensuring all personal identifiers were encrypted to uphold patient confidentiality.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eAcute coma participants definition\u003c/h2\u003e \u003cp\u003eGiven the nature of this study, we utilized the NHIRD dataset to investigate acute coma incidences. However, it should be noted that the NHIRD dataset lacks specific indicators like the Glasgow Coma Scale (GCS) to represent coma status. Consequently, we relied on the judgment of emergency physicians in diagnosing acute coma instances, especially in cases where there was no explicit diagnosis but an indication of coma in the ED's diagnoses. We employed International Classification of Diseases (ICD) codes to define acute coma objectively. These codes encompass a range of acute coma conditions, including \"780.01\" for comatose, \"780.09\" for other alterations of consciousness, \"R40.0\" for somnolence, \"R40.1\" for stupor, \"R40.2\" for unspecified coma, and \"S06.7\" for intracranial injury-related coma. Therefore, our study population consisted of cases that included any of these codes within the three diagnoses upon ED discharge records and remained as the final research cohort (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The present study implemented several exclusion criteria to ensure precise estimation of the cause, disease progression, and clinical outcomes associated with acute coma. First, we omitted cases lacking comprehensive sociodemographic data. Second, we excluded those who were undergoing life-sustaining treatments or were disabled or residing in a nursing home prior to the acute coma event. Additionally, cases diagnosed with acute coma in the ED that CCS could not further classify were removed from the study. To rule out hospitalizations potentially unrelated to the acute coma events, we excluded samples hospitalized more than 14 days following the acute coma.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eIncidence estimates\u003c/h2\u003e \u003cp\u003eWe estimated the annual acute coma event rate from 2000 to 2017, with acute coma events as the unit of analysis. The event rate of acute coma is calculated by dividing the number of events by ED visits. In addition, we determined crude age group-stratified incidence rates were determined per 1000 person-years, with denominators based on the number of insured individuals during the year, taking into account their survival status and the person-years they contributed within that year. Considering insured individuals' survival status and person-years contributed and reported age-specific incidence rates in pediatric (\u003cspan additionalcitationids=\"CR2 CR3 CR4 CR5 CR6 CR7 CR8 CR9 CR10 CR11 CR12 CR13 CR14 CR15 CR16 CR17\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e), adult (19\u0026ndash;64), and senior adult (65+) groups with corresponding summary statistics.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eClinical course, causes and outcomes assessment\u003c/h2\u003e \u003cp\u003eThe study explored the \u003cb\u003eclinical course\u003c/b\u003e of acute coma using each patient's first-ever event as the unit of analysis. Index date was set as the date of first diagnosis acute coma. ED visits were categorized into reversible coma, hospitalization, and 30-day mortality \u003csup\u003e13\u003c/sup\u003e. Individuals who died within 30 days of the acute coma ED index date were classified as the 30-day mortality group. Those requiring hospitalization within seven days post-episode but not dying within 30 days constituted the hospitalization group. Patients diagnosed with acute coma in the ED without needing hospitalization or facing death were categorized as the reversible coma group.\u003c/p\u003e \u003cp\u003eUsing CCS methodology \u003csup\u003e12 14 15\u003c/sup\u003e, we categorized ICD codes from death or hospitalization into 23 \u003cb\u003eacute coma causes\u003c/b\u003e (Supplementary Table\u0026nbsp;1) and a statistical analysis plan is available in the (Supplementary Program). The diagnosis sequence began with death, hospitalization, and ED diagnosis if no death or hospitalization occured. These causes were further classified into three \u003cb\u003eetiological mechanisms\u003c/b\u003e: (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) primary CNS diseases (neurological etiology), (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) medical conditions affecting the CNS secondarily (medical etiology), and (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) functional etiology\u003csup\u003e5\u003c/sup\u003e. Neurological etiology included acute CNS insult, chronic neurodegenerative encephalopathy, paroxysmal seizure disorders, and brain trauma. Medical etiology included alcohol-related coma, drugs, and organ system dysfunction. Functional factors included psychogenic disorders, symptoms, syncope, and other related causes. Patients were followed for one year to evaluate short-term outcome (30-day mortality or reversible course) and long-term outcomes (ICU admission, LSTs \u003csup\u003e16\u003c/sup\u003e, rehabilitation, disability status, or nursing home residency).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eWe used χ\u0026sup2; tests to analyze baseline categorical characteristics and compared continuous variables' mean among coma groups with One-Way ANOVA. Generalized estimating equations (GEE ) were used to estimate the adjusted odds ratio (aOR) of acute coma, accounting for multiple causes and covariates like sex, age, CCI, occupation, urbanization, and income. Survival analysis was conducted for reversible and hospitalization groups, tracking survival probability and calculating time to event (death) or censoring. Cox regression investigated potential death event causes, with hazard ratios identifying factors affecting long-term outcomes. Analyses were performed with SAS software, version 9.4, and a significance level of p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eCohort characteristics and clinical course estimate\u003c/h2\u003e \u003cp\u003eAmong 99,217,322 ED visits between 2000 and 2017, 419,480 acute coma events were identified. Of these, 365,675 patients were discharged or hospitalized within seven days. After excluding 4,385 ED visits with only acute coma diagnosis code, lacking further information, and participants lacking sociodemographic data or with prior nursing home or disabled status, 205,747 cases remained in the final research cohort (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The cohort clinical course classified 93,598 (45.49%) as reversible acute coma group, 85,712 (41.66%) as hospitalization group, and 26,437 (12.85%) as 30-day mortality group. The study population was 54.39% male, with an average age of 58.27 (SD 23.04) years (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCharacteristics of acute coma cohort\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eTotal acute coma\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eReversible coma\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003eHospitalization\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e30-day mortality\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e205,747\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(100\u0026middot;00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e93,598\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(45\u0026middot;49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e85,712\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(41\u0026middot;66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e26,437\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(12\u0026middot;85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e111,897\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(54\u0026middot;39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e49,738\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(53\u0026middot;14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e46,910\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(54\u0026middot;73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e15,249\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(57\u0026middot;68)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e93,850\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(45\u0026middot;61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43,860\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(46\u0026middot;86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e38,802\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(45\u0026middot;27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e11,188\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(42\u0026middot;32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e58\u0026middot;27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026plusmn;\u0026thinsp;23\u0026middot;04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39\u0026middot;81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026plusmn;\u0026thinsp;19\u0026middot;99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e52\u0026middot;93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026plusmn;\u0026thinsp;22\u0026middot;93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e70\u0026middot;99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026plusmn;\u0026thinsp;16\u0026middot;90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge group\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61,756\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(30\u0026middot;02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e38,509\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(13\u0026middot;56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19,661\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(22\u0026middot;94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3,586\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(13\u0026middot;56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18\u0026ndash;64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e49,039\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(23\u0026middot;83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22,955\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(23\u0026middot;88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19,771\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(23\u0026middot;07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6,313\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(23\u0026middot;88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e≧\u0026thinsp;65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e94,952\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(46\u0026middot;15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32,134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(62\u0026middot;56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e46,280\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(53\u0026middot;99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e16,538\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(62\u0026middot;56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCCI index\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCCI\u0026thinsp;≦\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e133,867\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(65\u0026middot;06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e73,552\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(78\u0026middot;58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e46,694\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(54\u0026middot;48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e13,621\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(51\u0026middot;52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCCI\u0026thinsp;\u0026gt;\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e71,880\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(34\u0026middot;94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20,046\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(21\u0026middot;42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e39,018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(45\u0026middot;52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e12,816\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(48\u0026middot;48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIncome\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e58,488\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(28\u0026middot;43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26,255\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(28\u0026middot;05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e25,054\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(29\u0026middot;23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e7,179\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(27\u0026middot;15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMiddle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e73,869\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(35\u0026middot;90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35,899\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(38\u0026middot;35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e29,228\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(34\u0026middot;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e8,742\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(33\u0026middot;07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e73,390\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(35\u0026middot;67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31,444\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(33\u0026middot;60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e31,430\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(36\u0026middot;67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e10,516\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(39\u0026middot;78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOccupation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDependents of the insured individuals\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e62,271\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(30\u0026middot;27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27,616\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(29\u0026middot;50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e26,700\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(31\u0026middot;15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e7,955\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(30\u0026middot;09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCivil servants, teachers, military, veterans\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2,915\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(1\u0026middot;42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1,429\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(1\u0026middot;53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1,151\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(1\u0026middot;34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e335\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(1\u0026middot;27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNonmanual workers and professionals\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20,121\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(9\u0026middot;78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11,891\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(12\u0026middot;70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6,401\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(7\u0026middot;47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1,829\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(6\u0026middot;92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eManual workers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e72,036\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(35\u0026middot;01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29,707\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(31\u0026middot;74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e31,824\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(37\u0026middot;13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e10,505\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(39\u0026middot;73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e48,404\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(23\u0026middot;53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22,955\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(24\u0026middot;53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19,636\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(22\u0026middot;91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e5,813\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(21\u0026middot;99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eUrbanization\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e83,476\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(40\u0026middot;57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41,892\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(44\u0026middot;76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e31,882\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(37\u0026middot;20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e9,702\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(36\u0026middot;70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSuburban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e76,632\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(37\u0026middot;25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33,150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(35\u0026middot;42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e33,456\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(39\u0026middot;03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e10,026\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(37\u0026middot;92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45,639\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(22\u0026middot;18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18,556\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(19\u0026middot;82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e20,374\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(23\u0026middot;77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6,709\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(25\u0026middot;38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCauses of acute coma\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNeurological cause group\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e56,790\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(27\u0026middot;60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22,153\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(23\u0026middot;67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e24,430\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(28\u0026middot;50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e10,207\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(38\u0026middot;61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCNS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30,065\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(14\u0026middot;61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8,183\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(8\u0026middot;74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e14,639\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(17\u0026middot;08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e7,243\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(27\u0026middot;40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEncephalopathy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6,700\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(3\u0026middot;26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2,616\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(2\u0026middot;79)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3,573\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(4\u0026middot;17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e511\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(1\u0026middot;93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSeizure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2,225\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(1\u0026middot;08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1,157\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(1\u0026middot;24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1,020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(1\u0026middot;19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(0\u0026middot;18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTrauma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17,800\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(8\u0026middot;65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10,197\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(10\u0026middot;89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5,198\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(6\u0026middot;06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2,405\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(9\u0026middot;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMedical cause group\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e137,330\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(66\u0026middot;75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e65,158\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(69\u0026middot;61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e57,007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(66\u0026middot;51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e15,165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(57\u0026middot;36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlcohol\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2,533\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(1\u0026middot;23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2,255\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(2\u0026middot;41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e257\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(0\u0026middot;30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(0\u0026middot;08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCardiovascular\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19,367\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(9\u0026middot;41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7,938\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(8\u0026middot;48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8,148\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(9\u0026middot;51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3,281\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(12\u0026middot;41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiabetes and insulin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11,155\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(5\u0026middot;42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4,178\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(4\u0026middot;46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5,529\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(6\u0026middot;45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1,448\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(5\u0026middot;48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDigestive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19,904\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(9\u0026middot;67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9,364\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(10\u0026middot;00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7,968\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(9\u0026middot;30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2,572\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(9\u0026middot;73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDrugs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5,036\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(2\u0026middot;45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2,002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(2\u0026middot;14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1,941\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(2\u0026middot;26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1,093\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(4\u0026middot;13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElectrolyte\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e456\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(0\u0026middot;22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e249\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(0\u0026middot;27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e152\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(0\u0026middot;18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(0\u0026middot;21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEndocrine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2,427\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(1\u0026middot;18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1,086\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(1\u0026middot;16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e904\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(1\u0026middot;05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e437\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(1\u0026middot;65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGenitourinary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3,463\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(1\u0026middot;68)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1,836\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(1\u0026middot;96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1,327\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(1\u0026middot;55)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(1\u0026middot;13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHematology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e587\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(0\u0026middot;29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e292\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(0\u0026middot;31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e228\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(0\u0026middot;27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(0\u0026middot;25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInfection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31,063\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(15\u0026middot;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14,714\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(15\u0026middot;72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e14,005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(16\u0026middot;34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2,344\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(8\u0026middot;87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMusculoskeletal and integumentary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6,144\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(2\u0026middot;99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3,659\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(3\u0026middot;91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2,208\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(2\u0026middot;58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e277\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(1\u0026middot;05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeoplasm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10,062\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(4\u0026middot;89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3,938\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(4\u0026middot;21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4,459\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(5\u0026middot;20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1,665\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(6\u0026middot;30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRenal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3,564\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(1\u0026middot;73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1,149\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(1\u0026middot;23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1,884\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(2\u0026middot;20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e531\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(2\u0026middot;01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRespiratory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9,419\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(4\u0026middot;58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3,550\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(3\u0026middot;79)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5,007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(5\u0026middot;84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e862\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(3\u0026middot;26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWomen's health and perinatal care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12,150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(5\u0026middot;91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8,948\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(9\u0026middot;56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2,990\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(3\u0026middot;49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e212\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(0\u0026middot;80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFunctional cause group\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11,627\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(5\u0026middot;65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6,287\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(6\u0026middot;72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4,275\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(4\u0026middot;99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1,065\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(4\u0026middot;03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePsychiatry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4,765\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(2\u0026middot;32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2,923\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(3\u0026middot;12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1,827\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(2\u0026middot;13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(0\u0026middot;06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSymptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1,379\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(0\u0026middot;67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e881\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(0\u0026middot;94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e342\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(0\u0026middot;40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e156\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(0\u0026middot;59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSyncope\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e521\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(0\u0026middot;25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e352\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(0\u0026middot;38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e169\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(0\u0026middot;20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(0\u0026middot;00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4,962\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(2\u0026middot;41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2,131\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(2\u0026middot;28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1,937\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(2\u0026middot;26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e894\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(3\u0026middot;38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOutcome\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eICU\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e54,614\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(26\u0026middot;54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(0\u0026middot;00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e39,144\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(45\u0026middot;67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e15,470\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(58\u0026middot;52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLSTs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e84,538\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(41\u0026middot;09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10,578\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(11\u0026middot;30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e50,056\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(58\u0026middot;40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e23,904\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(90\u0026middot;42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRehab\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29,273\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(14\u0026middot;23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4,816\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(5\u0026middot;15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e23,728\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(27\u0026middot;68)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e729\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(2\u0026middot;76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNursing home\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3,861\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(1\u0026middot;88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e492\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(0\u0026middot;53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3,261\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(3\u0026middot;80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e108\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(0\u0026middot;41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13,514\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(6\u0026middot;57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2,856\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(3\u0026middot;05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10,629\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e(12\u0026middot;40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e(0\u0026middot;11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"10\"\u003eCCI: Charlson Comorbidity Index; CI: confidence interval; CNS: central nervous system; ED: emergency department; ICU: intensive care units; LST: life-sustaining treatment;\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"10\"\u003eChi-Square Test analyzed category variables distribution among groups; continue variable by One-way ANOVA\u0026middot;\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eIncidence of acute coma\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e analyzes ICD diagnosis codes for acute coma events, revealing: (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) a crude event rate of 4.23 per 1,000 ED visits, (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) an average incidence rate of 0.93 per 1,000 person-years, and (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) age-specific incidence rates: 0.13 for pediatric, 0.57 for middle-aged, and 7.13 for senior adult groups. A significant mean decrease in incidence rate in 2016 suggests that age and temporal factors may influence acute coma incidence.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAcute coma event rate and incidence by year and age group\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"12\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYear\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eED visits\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eComa events\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eComa rate\u003c/p\u003e \u003cp\u003e(\u0026permil;)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eIncidence\u003c/p\u003e \u003cp\u003e(\u0026permil;) (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003eAge 1\u0026ndash;18 Incidence\u003c/p\u003e \u003cp\u003e(\u0026permil;) (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e \u003cp\u003eAge 19\u0026ndash;64 Incidence\u003c/p\u003e \u003cp\u003e(\u0026permil;) (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c12\" namest=\"c11\"\u003e \u003cp\u003eAge\u0026thinsp;≧\u0026thinsp;65 Incidence\u003c/p\u003e \u003cp\u003e(\u0026permil;) (95% CI)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4,519,482\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10,330\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u0026middot;29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026middot;45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(0\u0026middot;44\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c8\"\u003e \u003cp\u003e(0\u0026middot;08\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c10\"\u003e \u003cp\u003e(0\u0026middot;30\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e7\u0026middot;74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e(7\u0026middot;53\u0026thinsp;\u0026minus;\u0026thinsp;7\u0026middot;95)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4,707,002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11,480\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u0026middot;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026middot;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(0\u0026middot;48\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c8\"\u003e \u003cp\u003e(0\u0026middot;08\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c10\"\u003e \u003cp\u003e(0\u0026middot;32\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e7\u0026middot;77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e(7\u0026middot;57\u0026thinsp;\u0026minus;\u0026thinsp;7\u0026middot;97)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5,028,446\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12,567\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u0026middot;50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026middot;53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(0\u0026middot;52\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c8\"\u003e \u003cp\u003e(0\u0026middot;09\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c10\"\u003e \u003cp\u003e(0\u0026middot;33\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e7\u0026middot;78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e(7\u0026middot;59\u0026thinsp;\u0026minus;\u0026thinsp;7\u0026middot;97)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4,776,136\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13,246\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u0026middot;77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026middot;56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(0\u0026middot;55\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c8\"\u003e \u003cp\u003e(0\u0026middot;09\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c10\"\u003e \u003cp\u003e(0\u0026middot;35\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e7\u0026middot;21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e(7\u0026middot;04\u0026ndash;7\u0026middot;38)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5,354,185\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16,072\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3\u0026middot;00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026middot;67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(0\u0026middot;66\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;68)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c8\"\u003e \u003cp\u003e(0\u0026middot;10\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c10\"\u003e \u003cp\u003e(0\u0026middot;43\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e7\u0026middot;58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e(7\u0026middot;41\u0026thinsp;\u0026minus;\u0026thinsp;7\u0026middot;74)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5,416,581\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20,535\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3\u0026middot;79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026middot;85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(0\u0026middot;83\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c8\"\u003e \u003cp\u003e(0\u0026middot;11\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c10\"\u003e \u003cp\u003e(0\u0026middot;54\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e8\u0026middot;80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e(8\u0026middot;63\u0026thinsp;\u0026minus;\u0026thinsp;8\u0026middot;97)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2006\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5,171,689\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21,769\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4\u0026middot;21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026middot;89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(0\u0026middot;88\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c8\"\u003e \u003cp\u003e(0\u0026middot;12\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c10\"\u003e \u003cp\u003e(0\u0026middot;56\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e8\u0026middot;59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e(8\u0026middot;43\u0026thinsp;\u0026minus;\u0026thinsp;8\u0026middot;75)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5,282,870\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23,591\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4\u0026middot;47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026middot;96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(0\u0026middot;94\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c8\"\u003e \u003cp\u003e(0\u0026middot;12\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c10\"\u003e \u003cp\u003e(0\u0026middot;57\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e8\u0026middot;74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e(8\u0026middot;59\u0026thinsp;\u0026minus;\u0026thinsp;8\u0026middot;89)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2008\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5,191,529\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25,548\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4\u0026middot;92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u0026middot;02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(1\u0026middot;01\u0026ndash;1\u0026middot;04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c8\"\u003e \u003cp\u003e(0\u0026middot;13\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c10\"\u003e \u003cp\u003e(0\u0026middot;62\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e8\u0026middot;53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e(8\u0026middot;39\u0026thinsp;\u0026minus;\u0026thinsp;8\u0026middot;67)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5,770,750\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27,062\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4\u0026middot;69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u0026middot;08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(1\u0026middot;07\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c8\"\u003e \u003cp\u003e(0\u0026middot;14\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c10\"\u003e \u003cp\u003e(0\u0026middot;64\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e8\u0026middot;43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e(8\u0026middot;30\u0026thinsp;\u0026minus;\u0026thinsp;8\u0026middot;57)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5,878,033\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31,184\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u0026middot;31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u0026middot;23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(1\u0026middot;22\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c8\"\u003e \u003cp\u003e(0\u0026middot;16\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c10\"\u003e \u003cp\u003e(0\u0026middot;71\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e9\u0026middot;27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e(9\u0026middot;13\u0026thinsp;\u0026minus;\u0026thinsp;9\u0026middot;41)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6,060,366\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33,944\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u0026middot;60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u0026middot;33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(1\u0026middot;32\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c8\"\u003e \u003cp\u003e(0\u0026middot;18\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c10\"\u003e \u003cp\u003e(0\u0026middot;78\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e9\u0026middot;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e(9\u0026middot;11\u0026thinsp;\u0026minus;\u0026thinsp;9\u0026middot;37)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6,098,194\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34,259\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u0026middot;62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u0026middot;33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(1\u0026middot;32\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c8\"\u003e \u003cp\u003e(0\u0026middot;18\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c10\"\u003e \u003cp\u003e(0\u0026middot;78\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e8\u0026middot;60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e(8\u0026middot;47\u0026thinsp;\u0026minus;\u0026thinsp;8\u0026middot;72)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5,753,114\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33,531\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u0026middot;83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u0026middot;29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(1\u0026middot;28\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c8\"\u003e \u003cp\u003e(0\u0026middot;19\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c10\"\u003e \u003cp\u003e(0\u0026middot;75\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e7\u0026middot;80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e(7\u0026middot;69\u0026thinsp;\u0026minus;\u0026thinsp;7\u0026middot;91)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5,904,262\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34,917\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u0026middot;91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u0026middot;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(1\u0026middot;32\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c8\"\u003e \u003cp\u003e(0\u0026middot;18\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c10\"\u003e \u003cp\u003e(0\u0026middot;77\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;79)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e7\u0026middot;48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e(7\u0026middot;38\u0026thinsp;\u0026minus;\u0026thinsp;7\u0026middot;59)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6,055,577\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33,366\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u0026middot;51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u0026middot;27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(1\u0026middot;25\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c8\"\u003e \u003cp\u003e(0\u0026middot;19\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c10\"\u003e \u003cp\u003e(0\u0026middot;72\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e6\u0026middot;57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e(6\u0026middot;47\u0026thinsp;\u0026minus;\u0026thinsp;6\u0026middot;66)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6,303,662\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19,355\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3\u0026middot;07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026middot;73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(0\u0026middot;72\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c8\"\u003e \u003cp\u003e(0\u0026middot;09\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c10\"\u003e \u003cp\u003e(0\u0026middot;38\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e3\u0026middot;70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e(3\u0026middot;63\u0026thinsp;\u0026minus;\u0026thinsp;3\u0026middot;76)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5,945,444\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16,724\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u0026middot;81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026middot;63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(0\u0026middot;62\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c8\"\u003e \u003cp\u003e(0\u0026middot;07\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026minus;\" colname=\"c10\"\u003e \u003cp\u003e(0\u0026middot;32\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e2\u0026middot;96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e(2\u0026middot;90\u0026thinsp;\u0026minus;\u0026thinsp;3\u0026middot;02)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003cp\u003eAverage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e99,217,322\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e419,480\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4\u0026middot;23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026middot;93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(0\u0026middot;93\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e(0\u0026middot;13\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e(0\u0026middot;57\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e7\u0026middot;13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e(7\u0026middot;10\u0026thinsp;\u0026minus;\u0026thinsp;7\u0026middot;16)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"12\"\u003eCI: confidence interval; ED: emergency department;\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"12\"\u003eComa rate(\u0026permil;)\u0026thinsp;=\u0026thinsp;acute coma events/1,000ED visits\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"12\"\u003eIncidence of acute coma per 1,000 person-year\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eCauses and outcomes of acute coma\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents leading acute coma causes, including infection (15.10%), CNS (14.61%), digestive (9.67%), cardiovascular (9.41%), and trauma-related (8.65%). Common reversible causes included infection (15.72%), trauma (10.89%), digestive (10.00%), women's health and perinatal care (9.56%), and CNS (8.74%). Hospitalization for acute coma frequently resulted from CNS (17.08%), infection (16.34%), cardiovascular (9.51%), digestive (9.30%), and diabetes and insulin (6.45%). Leading causes of death were CNS (27.40%), cardiovascular (12.41%), digestive (9.73%), trauma (9.10%), and infection (8.87%). Medical etiologies were the primary factor (66.75%), with neurological (27.60%) and functional (5.65%) etiologies also contributing. Short-term outcomes indicated 45.49% of cases left the ED without sequelae, 12.85% experienced 30-day mortality, and 41.66% necessitated hospitalization within seven days. Elderly patients had a significantly higher mortality rate of 62.56% compared to 11.56% for younger patients. The one-year follow-up showed ICU treatment (26.54%), LSTs (41.09%), rehabilitation (14.23%), disability (6.57%), and nursing care (1.88%).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eMultivariate analysis of acute coma\u003c/h2\u003e \u003cp\u003eThe GEE analysis identified covariates significantly associated with increased acute coma mortality, including females, older age, higher Charlson Comorbidity Index (CCI) scores, low income, and rural residence (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Compared to other causes, CNS (adjusted odds ratio [aOR], 0.68; 95% CI: 0.62 to 0.74; p\u0026thinsp;\u0026lt;\u0026thinsp;.0001) and drug-related causes (aOR, 0.72; 95% CI: 0.65 to 0.81; p\u0026thinsp;\u0026lt;\u0026thinsp;.0001) had lower odds of reversible coma compared to 30-day mortality, while psychiatric (aOR, 57.02; 95% CI: 34.11 to 95.33; p\u0026thinsp;\u0026lt;\u0026thinsp;.0001), alcohol (aOR, 33.8; 95% CI: 21.81 to 52.38; p\u0026thinsp;\u0026lt;\u0026thinsp;.0001), women's health and perinatal care (aOR, 11.86; 95% CI: 10.11 to 13.92; p\u0026thinsp;\u0026lt;\u0026thinsp;.0001), seizures (aOR, 8.32; 95% CI: 6.15 to 11.24; p\u0026thinsp;\u0026lt;\u0026thinsp;.0001), and musculoskeletal/integumentary causes (aOR, 8.16; 95% CI: 7.04 to 9.47; p\u0026thinsp;\u0026lt;\u0026thinsp;.0001) had higher odds. Drug causes had lower odds of hospitalization compared to mortality (aOR, 0.82; 95% CI: 0.73 to 0.91; p\u0026thinsp;=\u0026thinsp;.0003), while psychiatry (aOR, 48.29; 95% CI: 28.88 to 80.77; p\u0026thinsp;\u0026lt;\u0026thinsp;.0001), seizure (aOR, 9.01; 95% CI: 6.67 to 12.17; p\u0026thinsp;\u0026lt;\u0026thinsp;.0001), women's health and perinatal care (aOR, 5.44; 95% CI: 4.63 to 6.40; p\u0026thinsp;\u0026lt;\u0026thinsp;.0001), and alcohol (aOR, 5.20; 95% CI: 3.31 to 8.17; p\u0026thinsp;\u0026lt;\u0026thinsp;.0001) causes increased the odds. Compared to functional etiology, neurological etiology had lower odds of reversible coma (aOR, 0.55; 95% CI, 0.51 to 0.59, p\u0026thinsp;\u0026lt;\u0026thinsp;.0001) and hospitalization (aOR, 0.70; 95% CI 0.65 to 0.75, p\u0026thinsp;\u0026lt;\u0026thinsp;.0001), while medical etiology had higher odds of reversible coma (aOR, 1.39; 95% CI: 1.30 to 1.49, p\u0026thinsp;\u0026lt;\u0026thinsp;.0001) and hospitalization (aOR, 1.16; 95% CI: 1.09 to 1.25, p\u0026thinsp;\u0026lt;\u0026thinsp;.0001).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eGeneralized linear model analysis of acute coma patients\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c6\" namest=\"c3\"\u003e \u003cp\u003eReversible coma v.s. 30-day mortality\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c10\" namest=\"c7\"\u003e \u003cp\u003eHospitalization v.s. 30-day mortality\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eOR (95%CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eaOR (95%CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eOR (95%CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eaOR (95%CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale vs Female\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026middot;20 (1\u0026middot;17\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u0026middot;29 (1\u0026middot;25\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u0026middot;13 (1\u0026middot;10\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1\u0026middot;14 (1\u0026middot;10\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19\u0026ndash;64 vs\u0026thinsp;\u0026le;\u0026thinsp;18 years old\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026middot;34 (0\u0026middot;32\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026middot;44 (0\u0026middot;42\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;57 (0\u0026middot;55\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;59 (0\u0026middot;56\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;65 vs\u0026thinsp;\u0026le;\u0026thinsp;18 years old\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026middot;18 (0\u0026middot;17\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026middot;26 (0\u0026middot;25\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;51 (0\u0026middot;49\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;44 (0\u0026middot;42\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCCI\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;1 vs\u0026thinsp;\u0026le;\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026middot;29 (0\u0026middot;28\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026middot;44 (0\u0026middot;42\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;89 (0\u0026middot;87\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1\u0026middot;04 (1\u0026middot;01\u0026ndash;1\u0026middot;07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0\u0026middot;0219\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIncome\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMiddle vs low group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026middot;22 (1\u0026middot;18\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u0026middot;58 (1\u0026middot;52\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u0026middot;17 (1\u0026middot;13\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1\u0026middot;30 (1\u0026middot;25\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigh vs low group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026middot;37 (1\u0026middot;33\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u0026middot;33 (1\u0026middot;28\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u0026middot;12 (1\u0026middot;08\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1\u0026middot;12 (1\u0026middot;09\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOccupation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDependents of the insured individuals vs others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026middot;82 (0\u0026middot;72\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026middot;0012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026middot;83 (0\u0026middot;73\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u0026middot;0055\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;98 (0\u0026middot;87\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u0026middot;7416\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;94 (0\u0026middot;83\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0\u0026middot;3469\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCivil servants, teachers, military, veterans vs others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026middot;53 (1\u0026middot;34\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026middot;93 (0\u0026middot;81\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u0026middot;3002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u0026middot;02 (0\u0026middot;89\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u0026middot;774\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;84 (0\u0026middot;74\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0\u0026middot;0136\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNonmanual workers and professionals vs others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026middot;67 (0\u0026middot;59\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026middot;84 (0\u0026middot;74\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u0026middot;0084\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;88 (0\u0026middot;78\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u0026middot;0503\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;89 (0\u0026middot;78\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0\u0026middot;0799\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eManual workers vs others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026middot;93 (0\u0026middot;82\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026middot;2501\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u0026middot;04 (0\u0026middot;91\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u0026middot;6073\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;99 (0\u0026middot;87\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u0026middot;8258\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1\u0026middot;01 (0\u0026middot;89\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0\u0026middot;8776\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eUrbanization\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026middot;77 (0\u0026middot;74\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;79)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026middot;83 (0\u0026middot;80\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u0026middot;02 (0\u0026middot;98\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u0026middot;3561\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1\u0026middot;05 (1\u0026middot;01\u0026ndash;1\u0026middot;08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0\u0026middot;0064\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrbanization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026middot;64 (0\u0026middot;62\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026middot;77 (0\u0026middot;74\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;92 (0\u0026middot;89\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;98 (0\u0026middot;94\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0\u0026middot;2124\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCauses of coma\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eNeurological group\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026middot;37 (0\u0026middot;34\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026middot;55 (0\u0026middot;51\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;60 (0\u0026middot;56\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;70 (0\u0026middot;65\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCNS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026middot;47 (0\u0026middot;44\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026middot;68 (0\u0026middot;62\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;93 (0\u0026middot;86\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u0026middot;1051\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1\u0026middot;09 (1\u0026middot;00\u0026ndash;1\u0026middot;19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0\u0026middot;0517\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEncephalopathy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u0026middot;15 (1\u0026middot;90\u0026thinsp;\u0026minus;\u0026thinsp;2\u0026middot;43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4\u0026middot;08 (3\u0026middot;59\u0026thinsp;\u0026minus;\u0026thinsp;4\u0026middot;63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3\u0026middot;23 (2\u0026middot;86\u0026thinsp;\u0026minus;\u0026thinsp;3\u0026middot;65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e4\u0026middot;24 (3\u0026middot;75\u0026thinsp;\u0026minus;\u0026thinsp;4\u0026middot;80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSeizure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u0026middot;11 (7\u0026middot;50\u0026thinsp;\u0026minus;\u0026thinsp;13\u0026middot;64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8\u0026middot;32 (6\u0026middot;15\u0026thinsp;\u0026minus;\u0026thinsp;11\u0026middot;24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e9\u0026middot;81 (7\u0026middot;27\u0026thinsp;\u0026minus;\u0026thinsp;13\u0026middot;24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e9\u0026middot;01 (6\u0026middot;67\u0026thinsp;\u0026minus;\u0026thinsp;12\u0026middot;17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTrauma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026middot;78 (1\u0026middot;63\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u0026middot;75 (1\u0026middot;59\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u0026middot;00 (0\u0026middot;91\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u0026middot;9585\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1\u0026middot;02 (0\u0026middot;92\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0\u0026middot;7595\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eMedical group\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026middot;73 (0\u0026middot;68\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u0026middot;39 (1\u0026middot;30\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;94 (0\u0026middot;87\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u0026middot;0641\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1\u0026middot;16 (1\u0026middot;09\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlcohol\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45\u0026middot;05 (29\u0026middot;11\u0026ndash;69\u0026middot;72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e33\u0026middot;8 (21\u0026middot;81\u0026thinsp;\u0026minus;\u0026thinsp;52\u0026middot;38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5\u0026middot;65 (3\u0026middot;60\u0026thinsp;\u0026minus;\u0026thinsp;8\u0026middot;88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e5\u0026middot;20 (3\u0026middot;31\u0026thinsp;\u0026minus;\u0026thinsp;8\u0026middot;17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCardiovascular\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026middot;02 (0\u0026middot;93\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026middot;7406\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u0026middot;04 (1\u0026middot;86\u0026thinsp;\u0026minus;\u0026thinsp;2\u0026middot;24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u0026middot;15 (1\u0026middot;05\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u0026middot;0027\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1\u0026middot;50 (1\u0026middot;37\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiabetes and insulin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026middot;21 (1\u0026middot;10\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3\u0026middot;13 (2\u0026middot;82\u0026thinsp;\u0026minus;\u0026thinsp;3\u0026middot;47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u0026middot;76 (1\u0026middot;60\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2\u0026middot;31 (2\u0026middot;09\u0026thinsp;\u0026minus;\u0026thinsp;2\u0026middot;55)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDigestive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026middot;53 (1\u0026middot;40\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u0026middot;53 (2\u0026middot;31\u0026thinsp;\u0026minus;\u0026thinsp;2\u0026middot;78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u0026middot;43 (1\u0026middot;31\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1\u0026middot;69 (1\u0026middot;54\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDrugs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026middot;77 (0\u0026middot;69\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u0026middot;72 (0\u0026middot;65\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;82 (0\u0026middot;74\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u0026middot;0003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0\u0026middot;82 (0\u0026middot;73\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0\u0026middot;0003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eElectrolyte\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026middot;90 (1\u0026middot;40\u0026thinsp;\u0026minus;\u0026thinsp;2\u0026middot;57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u0026middot;96 (2\u0026middot;17\u0026thinsp;\u0026minus;\u0026thinsp;4\u0026middot;04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u0026middot;28 (0\u0026middot;93\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u0026middot;1342\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1\u0026middot;53 (1\u0026middot;11\u0026thinsp;\u0026minus;\u0026thinsp;2\u0026middot;11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0\u0026middot;0091\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEndocrine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026middot;04 (0\u0026middot;91\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026middot;5473\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u0026middot;49 (1\u0026middot;29\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026middot;96 (0\u0026middot;83\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u0026middot;5139\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1\u0026middot;15 (1\u0026middot;00\u0026ndash;1\u0026middot;32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0\u0026middot;0521\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGenitourinary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u0026middot;57 (2\u0026middot;22\u0026thinsp;\u0026minus;\u0026thinsp;2\u0026middot;97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4\u0026middot;41 (3\u0026middot;80\u0026thinsp;\u0026minus;\u0026thinsp;5\u0026middot;12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2\u0026middot;04 (1\u0026middot;76\u0026thinsp;\u0026minus;\u0026thinsp;2\u0026middot;37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2\u0026middot;59 (2\u0026middot;23\u0026thinsp;\u0026minus;\u0026thinsp;3\u0026middot;01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHematology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026middot;83 (1\u0026middot;39\u0026thinsp;\u0026minus;\u0026thinsp;2\u0026middot;41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u0026middot;53 (1\u0026middot;90\u0026thinsp;\u0026minus;\u0026thinsp;3\u0026middot;36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u0026middot;57 (1\u0026middot;18\u0026thinsp;\u0026minus;\u0026thinsp;2\u0026middot;09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u0026middot;0018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1\u0026middot;83 (1\u0026middot;38\u0026thinsp;\u0026minus;\u0026thinsp;2\u0026middot;44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInfection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u0026middot;63 (2\u0026middot;41\u0026thinsp;\u0026minus;\u0026thinsp;2\u0026middot;88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4\u0026middot;26 (3\u0026middot;88\u0026thinsp;\u0026minus;\u0026thinsp;4\u0026middot;67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2\u0026middot;76 (2\u0026middot;52\u0026thinsp;\u0026minus;\u0026thinsp;3\u0026middot;02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3\u0026middot;36 (3\u0026middot;07\u0026thinsp;\u0026minus;\u0026thinsp;3\u0026middot;69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMusculoskeletal and integumentary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u0026middot;54 (4\u0026middot;79\u0026thinsp;\u0026minus;\u0026thinsp;6\u0026middot;41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8\u0026middot;16 (7\u0026middot;04\u0026ndash;9\u0026middot;47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3\u0026middot;68 (3\u0026middot;17\u0026thinsp;\u0026minus;\u0026thinsp;4\u0026middot;27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e4\u0026middot;35 (3\u0026middot;75\u0026thinsp;\u0026minus;\u0026thinsp;5\u0026middot;05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNeoplasm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026middot;99 (0\u0026middot;90\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026middot;8747\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u0026middot;06 (1\u0026middot;86\u0026thinsp;\u0026minus;\u0026thinsp;2\u0026middot;28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u0026middot;24 (1\u0026middot;12\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1\u0026middot;57 (1\u0026middot;42\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRenal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026middot;91 (0\u0026middot;80\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026middot;142\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u0026middot;30 (2\u0026middot;01\u0026ndash;2\u0026middot;62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u0026middot;64 (1\u0026middot;45\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2\u0026middot;21 (1\u0026middot;95\u0026thinsp;\u0026minus;\u0026thinsp;2\u0026middot;51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRespiratory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026middot;73 (1\u0026middot;55\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3\u0026middot;54 (3\u0026middot;16\u0026thinsp;\u0026minus;\u0026thinsp;3\u0026middot;96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2\u0026middot;68 (2\u0026middot;41\u0026thinsp;\u0026minus;\u0026thinsp;2\u0026middot;98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3\u0026middot;57 (3\u0026middot;20\u0026thinsp;\u0026minus;\u0026thinsp;3\u0026middot;98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWomen's health and perinatal care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17\u0026middot;71 (15\u0026middot;13\u0026ndash;20\u0026middot;72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11\u0026middot;86 (10\u0026middot;11\u0026ndash;13\u0026middot;92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6\u0026middot;51 (5\u0026middot;55\u0026thinsp;\u0026minus;\u0026thinsp;7\u0026middot;64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e5\u0026middot;44 (4\u0026middot;63\u0026thinsp;\u0026minus;\u0026thinsp;6\u0026middot;40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eFunctional group\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(ref\u0026middot; of coma group)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePsychiatry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e81\u0026middot;68 (48\u0026middot;90\u0026ndash;136\u0026middot;46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e57\u0026middot;02 (34\u0026middot;11\u0026ndash;95\u0026middot;33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e56\u0026middot;17 (33\u0026middot;59\u0026ndash;93\u0026middot;92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e48\u0026middot;29 (28\u0026middot;88\u0026thinsp;\u0026minus;\u0026thinsp;80\u0026middot;77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSymptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u0026middot;37 (1\u0026middot;97\u0026thinsp;\u0026minus;\u0026thinsp;2\u0026middot;86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2\u0026middot;78 (2\u0026middot;30\u0026thinsp;\u0026minus;\u0026thinsp;3\u0026middot;38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;0001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u0026middot;01 (0\u0026middot;82\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u0026middot;9106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1\u0026middot;11 (0\u0026middot;90\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0\u0026middot;3158\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSyncope\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(ref of causes of coma)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"10\"\u003eaOR: adjusted odds ratio; CCI: Charlson Comorbidity Index; CI: confidence interval; CNS: central nervous system; ED: emergency department; ICU: intensive care units; LST: life-sustaining treatment;\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"10\"\u003eSyncope: no convergence\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe Kaplan-Meier estimation (Supplementary Fig.\u0026nbsp;1) and Cox proportional hazards regression (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e) revealed increased mortality risk associated with higher CCI score (adjusted hazard ratios [aHR], 1.08, 95% CI 1.07 to 1.09, p\u0026thinsp;\u0026lt;\u0026thinsp;.001), older age (aHR, 2.17, 95% CI 2.13 to 2.22, p\u0026thinsp;\u0026lt;\u0026thinsp;.001), manual labor (aHR, 1.03, 95% CI 1.02 to 1.04, p\u0026thinsp;\u0026lt;\u0026thinsp;.001), drug (aHR, 1.30, 95% CI 1.20 to 1.41, p\u0026thinsp;\u0026lt;\u0026thinsp;.001), neoplasm (aHR, 1.18, 95% CI 1.11 to 1.25, p\u0026thinsp;\u0026lt;\u0026thinsp;.001), and symptoms cause (aHR, 1.44, 95% CI 1.24 to 1.67, p\u0026thinsp;\u0026lt;\u0026thinsp;.001). In addition, the average mortality post-acute coma for the reversible group was observed at 7.10 years, while for the hospitalization group, it occurred at 6.41 years.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultivariate Cox regression analysis of factors contributing to all-cause mortality in acute coma patients\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCox proportional hazards\u003c/p\u003e \u003cp\u003eaHR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex (male)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026middot;82 (0\u0026middot;80\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCCI (CCI\u0026thinsp;\u0026gt;\u0026thinsp;1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026middot;08 (1\u0026middot;07\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (old age)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u0026middot;17 (2\u0026middot;13\u0026ndash;2\u0026middot;22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIncome (high)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026middot;98 (0\u0026middot;97\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026middot;05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOccupation (manual)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026middot;03 (1\u0026middot;02\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eArea (urban)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026middot;02 (1\u0026middot;01\u0026ndash;1\u0026middot;04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026middot;01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNeurological group\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCNS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026middot;83 (0\u0026middot;79\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEncephalopathy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026middot;93 (0\u0026middot;87\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026middot;04\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSeizure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026middot;32 (0\u0026middot;26\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTrauma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026middot;48 (0\u0026middot;45\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMedical group\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlcohol\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026middot;39 (0\u0026middot;30\u0026ndash;0\u0026middot;51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCardiovascular\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026middot;94 (0\u0026middot;89\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026middot;02\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDigestive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026middot;91 (0\u0026middot;86\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDrugs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026middot;30 (1\u0026middot;20\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElectrolyte\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026middot;99 (0\u0026middot;78\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026middot;93\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEndocrine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026middot;76 (0\u0026middot;67\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGenitourinary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026middot;43 (0\u0026middot;38\u0026ndash;0\u0026middot;49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHematology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026middot;63 (0\u0026middot;49\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInfection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026middot;66 (0\u0026middot;63\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMusculoskeletal and integumentary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026middot;31 (0\u0026middot;28\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeoplasm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026middot;18 (1\u0026middot;11\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRenal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026middot;05 (0\u0026middot;97\u0026thinsp;\u0026minus;\u0026thinsp;1\u0026middot;13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026middot;21\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRespiratory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026middot;80 (0\u0026middot;75\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWomen's health and perinatal care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026middot;15 (0\u0026middot;13\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFunctional group\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePsychiatry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026middot;05 (0\u0026middot;03\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSymptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026middot;44 (1\u0026middot;24\u0026ndash;1\u0026middot;67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSyncope\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026middot;00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026middot;\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026middot;47 (0\u0026middot;42\u0026thinsp;\u0026minus;\u0026thinsp;0\u0026middot;53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0\u0026middot;001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003eAge (old age group), CCI (CCI\u0026thinsp;\u0026gt;\u0026thinsp;1 group), Income (high-income group), Area (urban), Occupation (manual), Sex (male)\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003eSyncope: no convergence\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eSensitivity test of acute coma\u003c/h2\u003e \u003cp\u003eTo assess the robustness of our findings, we focused on the definition of an acute coma cohort, explicitly examining the first-ever episode that led to hospitalization within either a 7-day or 14-day period. Our analysis revealed no significant differences between these two cohort definitions in terms of clinical course subgroup distribution and cause classification for acute coma (see Supplementary Table\u0026nbsp;2). This suggests that our findings are consistent and reliable across different definitions.\u003c/p\u003e \u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eAcute coma frequently represents a common pathway of organ dysfunction from diverse causes, significantly impacting patients' survival and quality of life and straining healthcare resources. This study aims to explore the incidence density, causes, clinical courses, and outcomes of acute coma. Several methodological and result issues warrant discussion.\u003c/p\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eMethodology discussion\u003c/h2\u003e \u003cp\u003eIn our 18-year longitudinal retrospective cohort study, we utilize the ICD coding system alongside the CCS method to navigate the complex etiology of acute coma. This complexity, stemming from an array of reversible and time-sensitive factors, creates challenges in synthesizing diverse clinical causes into a unified cohort for claims-based research. Previous studies have often relied on medical record reviews \u003csup\u003e17\u003c/sup\u003e or rigorously designed cohort studies\u003csup\u003e18\u003c/sup\u003e, lacking a comprehensive and longitudinal perspective. To bridge this research gap, we have devised an innovative clinical research model that integrates big data analytics with clinical investigation. This approach offers a novel framework for examining the multifaceted clinical scenarios related to acute coma through claims-based data, thereby opening new avenues for neuroscientific research and enhancing emergency medical decision-making systems.\u003c/p\u003e \u003cp\u003eStudy design, population and cohort definition\u003c/p\u003e \u003cp\u003eThe Taiwan NHIRD, encompassing the entire population and offering comprehensive medical services, facilitated a thorough analysis of acute coma's clinical nature. Besides, The large cohort of over 200,000 patients offered a robust population representation. Moreover, we defined the cohort based on one impaired consciousness in the ED study, where the average hospitalization duration was 6.4 days. Thereforee we included acute coma onset and hospitalization within seven days as our study cohort \u003csup\u003e19\u003c/sup\u003e. By excluding patients with prior nursing home residence or disability status, provids a better understanding of the true incidence and outcomes of first-ever acute coma. Meanwhile, the lack of clinical coma scale data raises concerns about the methodology accuracy, which relied on ICD coding and the CCS method. Our study adopted a broader definition of acute coma, using ICD codes, covering various alterations of consciousness such as somnolence, stupor, unspecified coma, and intracranial injury-related coma. Our study adopted a broad range of acute coma diagnosis codes to capture various clinical scenarios \u003csup\u003e20\u003c/sup\u003e. We used ICD coding methodology covering the qualitative spectrum of 'decreased consciousness,' including somnolence, stupor, coma, and quantitative GCS score ranges \u003csup\u003e20\u003c/sup\u003e. We also included the current quantitative approach to coma assessment, coding GCS scores of 13\u0026ndash;15 as R40.0, 9\u0026ndash;12 as R40.1, and \u0026le;\u0026thinsp;8 as R40.2. This approach ensured a thorough representation of acute coma in our research sample.\u003c/p\u003e \u003cp\u003eDefined of acute coma cause\u003c/p\u003e \u003cp\u003eIntegrating CCS with the ICD coding system in clinical research potentially offers a holistic and nuanced methodology for categorizing complex clinical data into clinically meaningful classes \u003csup\u003e14\u003c/sup\u003e. While established frameworks for transforming a myriad of ICD codes into clinically relevant categories that can guide clinical decision-making, inform policy interventions, or enable regular monitoring are not yet widespread \u003csup\u003e12\u003c/sup\u003e, In our study, we utilized CCS to condense 285 CCS categories into 23 clinically relevant causes of acute coma, rendering the study practically feasible and enabling the in-depth analysis of acute coma's multifaceted clinical manifestations. This approach facilitates large-scale, longitudinal population-based studies in EDs, optimizing approaches to address acute coma's clinical nature.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eResults discussion\u003c/h2\u003e \u003cp\u003eUnderstanding the clinical characteristics of acute coma makes it crucial for intensivist clinicians to identify the cause to prevent disability \u003csup\u003e21\u003c/sup\u003e and emergency medical policy applications.\u003c/p\u003e \u003cp\u003eCauses, clinical courses, and outcomes\u003c/p\u003e \u003cp\u003eInfections, CNS disorders, digestive issues, cardiovascular events, and trauma are leading causes of acute coma. Our research results are consistent with international findings, with infection being the most common cause \u003csup\u003e22 23\u003c/sup\u003e. Acute coma causes differ based on geography \u003csup\u003e24\u003c/sup\u003e or age \u003csup\u003e22\u003c/sup\u003e. For instance, poisoning contributes to approximately one-third of unconsciousness cases in Nordic countries \u003csup\u003e24\u003c/sup\u003e. In children, common causes are intoxication, epilepsy, infection, and traumatic brain injury \u003csup\u003e17\u003c/sup\u003e. In adults and older adults, CNS and infectious disorders are more common \u003csup\u003e17 20\u003c/sup\u003e. The prominence of digestive causes for acute coma in our cohort may be due to the prevalence of hepatitis and hepatocellular carcinoma in Taiwan \u003csup\u003e25\u003c/sup\u003e. To facilitate a broader understanding of public health implications related to the potential etiologies and mechanisms underlying acute coma, and to enable meaningful comparisons with existing literature, we have classified the etiologies of acute coma into three major categories: neurological, medical, and functional factors\u003csup\u003e5 6 26\u003c/sup\u003e. This categorization approach aids in the development of targeted intervention strategies and informs policy-making. Neurological causes account for about one-third of cases, while non-neurological causes comprise the remaining two-thirds \u003csup\u003e27\u003c/sup\u003e. Schmidt (2017) reported that neurological and medical etiologies each contributed to about 50% of acute coma cases \u003csup\u003e5\u003c/sup\u003e. Functional or psychogenic coma constituted around 5% of cases. It is worth further exploring the causes of coma resulting from functional factors.\u003c/p\u003e \u003cp\u003eThe clinical course of acute coma varies due to differing underlying causes or etiologies \u003csup\u003e9 22\u003c/sup\u003e. Over half of first-ever acute coma patients required hospitalization or faced mortality, whereas the other near half demonstrated reversible outcomes. Short-term in-hospital mortality rate for patients with acute coma is about 5\u0026ndash;11% \u003csup\u003e3 19 28\u003c/sup\u003e with longer follow-up reaching 25% \u003csup\u003e28\u003c/sup\u003e. Our study found that 27.60% of acute coma cases were attributed to neurological etiology, and within the mortality group, 38.16% of cases had a neurological cause. This supports prior research indicating that clinical course is highly dependent on etiology \u003csup\u003e22\u003c/sup\u003e. Syncope and seizures are generally believed to be the most common causes of reversible coma. However, in our study, these two common causes accounted for only 1.33% of cases of overall acute coma. This may support researchers' definition of coma as a state of prolonged sustained unconsciousness lasting at least one hour \u003csup\u003e29\u003c/sup\u003e. Our emergency physicians may better understand syncope and seizure, improving diagnostic accuracy \u003csup\u003e30\u003c/sup\u003e. Study showed that twenty percent of patients with acute coma may have already been reversible on admission \u003csup\u003e28\u003c/sup\u003e. If these patients are monitored for two months after hospitalization, one-third of them may fully recover consciousness \u003csup\u003e31\u003c/sup\u003e. Our study found that approximately 45.49% of patients had reversible coma. The higher proportion of reversible coma in our study may reflect a more lenient coding of coma or the higher quality of emergency medical care by emergency physicians in our study. These results suggest that the outcome of acute coma is highly dependent on the underlying cause and severity of the condition \u003csup\u003e32\u003c/sup\u003e. Regarding long-term outcomes, one-quarter of patients with first-ever acute coma necessitated ICU admission, and forty percent required LSTs within one year. The high percentage of patients in the LSTs group, who require long-term care and have a high mortality rate, emphasizes the need for improved management strategies for patients with acute coma \u003csup\u003e7\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIncidence\u003c/p\u003e \u003cp\u003eOur study found an acute coma event rate of 4.23 visits per 1,000 ED visits, consistent with the Schmidt et al. (2019) ED cohort study \u003csup\u003e28\u003c/sup\u003e. However, our results differ from another study that reported 0.29\u0026ndash;0.40 cases of coma per 1,000 ED visits \u003csup\u003e33\u003c/sup\u003e. Based on the ICD code approach, studies suggested that acute coma is about 0.93-5% of all ED visits \u003csup\u003e27 34\u003c/sup\u003e. Pediatric non-trauma coma studies also have reported incidences ranging from 0.3 to 1.6 per 1,000 person-years \u003csup\u003e22\u003c/sup\u003e. This disparity in results may be attributed to differences in research questions, study design, study population, or definitions \u003csup\u003e35\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eWe investigated the incidence rates of acute coma in different age groups and temporal trends. The highest incidence rate of acute coma was observed in the elderly age group, emphasizing the significance of this public health concern in the aging population. However, there is also some variability in the incidence rates over time. We found that the incidence rate stabilized at around 1 per 1,000 person-years from 2007 to 2015 and observed a significant mean decrease in the incidence rate in 2016 compared to previous years. Specifically, there was a significant mean decrease from 0.73 per 1,000 person-years in 2016 to 0.63 per 1,000 person-years in 2017. One possible explanation for the decrease in acute coma incidence during 2016\u0026ndash;2017 is the transition from the ICD-9 to ICD-10 coding system in 2015. We also found that there was no significant difference in the number of ED visits between 2014 and 2017 (5,904,262 vs 5,945,444, respectively). Thus, the significant change in acute coma incidence could be an artifact of the ICD coding transition effect \u003csup\u003e36\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eStrengths and Limitations\u003c/h2\u003e \u003cp\u003eThis study has several strengths and limitations. Strengths include using nationwide longitudinal data to observe first-ever acute coma patterns, enabling tracking of clinical progression. The average post-acute coma mortality occurring seven years highlights its importance as a risk factor and common pathway for mortality. Additionally, the study employed AHRQ CCS methodology, facilitating regular monitoring of acute coma clinical information and enabling tailored intervention plans.\u003c/p\u003e \u003cp\u003eThe present study has several limitations that need to be acknowledged. Firstly, the absence of a coma scale to accurately define the first-ever acute coma cohort represents a significant limitation. Instead, the study relied on acute coma-related diagnoses coded by emergency physicians in the ED, potentially leading to an underestimation of acute coma incidence and compromising the accuracy of identifying the causes of coma. Additionally, the conversion between ICD-9 and ICD-10 coding systems may introduce inaccuracies in estimating coma-related diagnoses due to potential discrepancies and inconsistencies in classification. Consequently, the reliability of the results may be affected. Furthermore, it is important to recognize that the acute coma diagnosis employed in this study may not fully capture the underlying causes or medical utilization, as multiple contributing pathologies could be involved due to potential multiple underlying pathologies \u003csup\u003e28\u003c/sup\u003e. The complexity of coma etiology, along with the potential presence of various underlying factors, may limit the accuracy of attributing the diagnosis to a single cause. Moreover, a small proportion (about 2%) of acute coma patients presented in the ED lacked further diagnostic information, which reflects the challenge in diagnosing cases of coma with unknown origins and introduces potential uncertainty and incomplete data in the analysis. Another limitation is the reliance on data limited to the year 2017, preventing the examination of the potential effects of the COVID-19 pandemic. Incorporating the impact of the pandemic would have enhanced the understanding of the significance of infections and central nervous system-related causes in estimating acute coma incidence. Finally, it should be noted that this study did not utilize the World Health Organization's (WHO) World Standard Population for age-specific rates adjustment, which may limit the generalizability and comparability of the findings with other studies that utilize standardized rates based on the WHO standard populations. These limitations should be considered when interpreting the study's results, and future research should address these limitations to enhance the robustness and applicability of the findings.\u003c/p\u003e \u003c/div\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eAcute coma often represents a common pathway of organ dysfunction with diverse causes or etiologies, significantly impacting mortality and disability. Our study demonstrates the innovative use of ICD code aggregation to CCS in acute coma clinical study, providing valuable insights into its clinical nature. This research model has the potential to facilitate international comparative studies of acute coma characteristics using health databases.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors have completed the ICMJE conflict of interest form and declare no conflicts of interest in relation to this manuscript. The study involved a retrospective analysis of encrypted unique personal identification data without direct patient involvement. Therefore, no patient consent was necessary for the completion of this study. As the corresponding author, I confirm that we complied with all applicable laws regarding data protection and privacy. No patients were involved. This study was a retrospective claim data analysis that included all encrypted unique personal identification. Ethics approval: IRB of Taipei City Hospital, number- TCHIRB-10807003-E.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePatients\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eor\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;the public\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;involvement:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePatients or the public were not involved in the design, or conduct, or reporting, or dissemination plans of our research\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data that support the findings of this study are available from Taiwan National Health Insurance Research Database but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the academic request and with permission of Taiwan National Health Insurance Administration.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConfirm the use of reporting checklist (see below), if appropriate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have confirmed the use of reporting checklists. We adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement when reporting observational studies and the Standards of Reporting of Neurological Disorders (STROND) for reporting incidence studies in neuroepidemiology.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributors\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCY Lin took a lead role in conceptualizing the study and writing the original draft, and was responsible for formal data analysis. CY Lin and CC Liu verified the underlying data in the manuscript. MC Tsai contributed to study design, data curation, and formal data analysis, and was in charge of data collection. JF Liang and MC Tsai ensured accurate data analysis and interpretation, and verified the manuscript\u0026apos;s underlying data. YC Lee supervised the study, validated the results, and significantly contributed to reviewing and editing the manuscript. All authors participated in developing the study concept and design, analysing and interpreting data, and preparing the manuscript. We have all approved the final manuscript and agree to be accountable for all aspects of the work, promising to appropriately investigate and resolve any question related to the work\u0026apos;s accuracy or integrity.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe acknowledge the Taiwan National Health Insurance Research Database, which was provided by the National Health Insurance Administration, and is managed by National Health Research Institutes. We also thank the Center for Public Health, Department of Education and Research, Taipei City Hospital, for providing administrative and research grant support.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1) \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Confirm that manuscript complies with all instructions to authors\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe authors confirm that our manuscript adheres to all the instructions provided for authors.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2) \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Confirm that authorship requirements (see below) have been met and the final manuscript was approved by all authors\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAll authors, coinvestigators, and contributors know and agree to the Authorship Policies outlined in the Author Center.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3) \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Confirm that this manuscript has not been published elsewhere and is not under consideration by another journal\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe authors confirm that this work is original, unpublished elsewhere and respectfully request its consideration for acceptance in the esteemed journal.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4) \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Confirm adherence to ethical guidelines and indicate ethical approvals (IRB) and use of informed consent, as appropriate (see below). Retrospective studies require a statement regarding IRB approval\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAll authors have completed the ICMJE conflict of interest form and declare no conflicts of interest in relation to this manuscript. The study involved a retrospective analysis of encrypted unique personal identification data without direct patient involvement. Therefore, no patient consent was necessary for the completion of this study. As the corresponding author, I confirm that we complied with all applicable laws regarding data protection and privacy. No patients were involved. This study was a retrospective claim data analysis that included all encrypted unique personal identification. Ethics approval: IRB of Taipei City Hospital, number- TCHIRB-10807003-E.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e5) \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Disclose Conflicts of Interest for all authors\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe authors report no disclosures relevant to the manuscript.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e6) \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Confirm the use of reporting checklist (see below), if appropriate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe authors have confirmed the use of reporting checklists. We adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement when reporting observational studies and the Standards of Reporting of Neurological Disorders (STROND) for reporting incidence studies in neuroepidemiology.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e7) \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Source of funding for the study\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe research grant supported by Taipei City Hospital\u003c/strong\u003e\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eLutz M, Mockel M, Lindner T, et al. The accuracy of initial diagnoses in coma: an observational study in 835 patients with non-traumatic disorder of consciousness. \u003cem\u003eScand J Trauma Resusc Emerg Med\u003c/em\u003e 2021;29(1):15. doi: 10.1186/s13049-020-00822-w\u003c/li\u003e\n\u003cli\u003eSamuels MA. A practical approach to coma diagnosis in the unresponsive patient. \u003cem\u003eCleve Clin J Med\u003c/em\u003e 1992;59(3):257-61.\u003c/li\u003e\n\u003cli\u003eXiao HY, Wang YX, Xu TD, et al. Evaluation and treatment of altered mental status patients in the emergency department: Life in the fast lane. \u003cem\u003eWorld J Emerg Med\u003c/em\u003e 2012;3(4):270-7. doi: 10.5847/wjem.j.1920-8642.2012.04.006\u003c/li\u003e\n\u003cli\u003eSamborska-Sablik A, Gaszyński W, Gaszyński T, et al. Coma - The interdisciplinary problem. \u003cem\u003ePolski Merkuriusz Lekarski\u003c/em\u003e 2005;18(108):703-08.\u003c/li\u003e\n\u003cli\u003eBraun M, Ploner CJ, Lindner T, et al. [Coma in the emergency room]. \u003cem\u003eNervenarzt\u003c/em\u003e 2017;88(6):607-15. doi: 10.1007/s00115-017-0329-8 [published Online First: 2017/04/21]\u003c/li\u003e\n\u003cli\u003eStevens RD, Bhardwaj A. Approach to the comatose patient. \u003cem\u003eCrit Care Med\u003c/em\u003e 2006;34(1):31-41.\u003c/li\u003e\n\u003cli\u003eWijdicks EFM. Predicting the outcome of a comatose patient at the bedside. \u003cem\u003ePract Neurol\u003c/em\u003e 2020;20(1):26-33. doi: 10.1136/practneurol-2019-002359 [published Online First: 2019/09/21]\u003c/li\u003e\n\u003cli\u003eHaupt WF, Hansen HC, Janzen RW, et al. Coma and cerebral imaging. \u003cem\u003eSpringerplus\u003c/em\u003e 2015;4:180. doi: 10.1186/s40064-015-0869-y [published Online First: 2015/05/20]\u003c/li\u003e\n\u003cli\u003eHelbok R, Rass V, Beghi E, et al. The Curing Coma Campaign International Survey on Coma Epidemiology, Evaluation, and Therapy (COME TOGETHER). \u003cem\u003eNeurocrit Care\u003c/em\u003e 2022;37(1):47-59. doi: 10.1007/s12028-021-01425-8 [published Online First: 20220209]\u003c/li\u003e\n\u003cli\u003eHorsting MW, Franken MD, Meulenbelt J, et al. The etiology and outcome of non-traumatic coma in critical care: a systematic review. \u003cem\u003eBMC Anesthesiol\u003c/em\u003e 2015;15(1):1-8.\u003c/li\u003e\n\u003cli\u003eCost H, Project U. Clinical classifications software (CCS) for ICD-9-CM. \u003cem\u003eAvailable at: www hcup-us ahrq gov/toolssoftware/ccs/ccs jsp Accessed February\u003c/em\u003e 2018;27\u003c/li\u003e\n\u003cli\u003eSalsabili M, Kiogou S, Adam TJ. The Evaluation of Clinical Classifications Software Using the National Inpatient Sample Database. \u003cem\u003eAMIA Jt Summits Transl Sci Proc\u003c/em\u003e 2020;2020:542-51. [published Online First: 20200530]\u003c/li\u003e\n\u003cli\u003eSrinivasan S, Bidkar PU. Approach to a Patient with Coma. Acute Neuro Care: Springer 2020:23-34.\u003c/li\u003e\n\u003cli\u003eQuality AfHRa. Clinical Classifications Software (CCS) for ICD-9-CM and ICD-10: Agency for Healthcare Research and Quality; [Available from: https://www.hcup-us.ahrq.gov/toolssoftware/ccs/ccs.jsp accessed March, 20 2021.\u003c/li\u003e\n\u003cli\u003eChute CG. Clinical classification and terminology: some history and current observations. \u003cem\u003eJ Am Med Inform Assoc\u003c/em\u003e 2000;7(3):298-303.\u003c/li\u003e\n\u003cli\u003eLin C-Y, Lee Y-C. Choosing and Doing wisely: triage level I resuscitation a possible new field for starting palliative care and avoiding low-value care \u0026ndash; a nationwide matched-pair retrospective cohort study in Taiwan. \u003cem\u003eBMC Palliat Care\u003c/em\u003e 2020;19(1):87. doi: 10.1186/s12904-020-00590-5\u003c/li\u003e\n\u003cli\u003eWong CP, Forsyth RJ, Kelly TP, et al. Incidence, aetiology, and outcome of non-traumatic coma: a population based study. \u003cem\u003eArch Dis Child\u003c/em\u003e 2001;84(3):193-9. doi: 10.1136/adc.84.3.193\u003c/li\u003e\n\u003cli\u003eSchmidt WU, Ploner CJ, Lutz M, et al. Causes of brain dysfunction in acute coma: a cohort study of 1027 patients in the emergency department. \u003cem\u003eScand J Trauma Resusc Emerg Med\u003c/em\u003e 2019;27(1):101. doi: 10.1186/s13049-019-0669-4 [published Online First: 2019/11/09]\u003c/li\u003e\n\u003cli\u003eVolk S, Koedel U, Pfister HW, et al. Impaired Consciousness in the Emergency Department. \u003cem\u003eEur Neurol\u003c/em\u003e 2018;80(3-4):179-86. doi: 10.1159/000495363\u003c/li\u003e\n\u003cli\u003eKekec Z, Senol V, Koc F, et al. Analysis of altered mental status in Turkey. \u003cem\u003eInt J Neurosci\u003c/em\u003e 2008;118(5):609-17. doi: 10.1080/00207450701849133 [published Online First: 2008/05/01]\u003c/li\u003e\n\u003cli\u003eProvencio JJ, Hemphill JC, Claassen J, et al. The Curing Coma Campaign: Framing Initial Scientific Challenges-Proceedings of the First Curing Coma Campaign Scientific Advisory Council Meeting. \u003cem\u003eNeurocrit Care\u003c/em\u003e 2020;33(1):1-12. doi: 10.1007/s12028-020-01028-9\u003c/li\u003e\n\u003cli\u003eWong C, Forsyth R, Kelly T, et al. Incidence, aetiology, and outcome of non-traumatic coma: a population based study. \u003cem\u003eArch Dis Child\u003c/em\u003e 2001;84(3):193-99.\u003c/li\u003e\n\u003cli\u003eSeshia SS, Bingham WT, Kirkham FJ, et al. Nontraumatic coma in children and adolescents: diagnosis and management. \u003cem\u003eNeurol Clin\u003c/em\u003e 2011;29(4):1007-43. doi: 10.1016/j.ncl.2011.07.011\u003c/li\u003e\n\u003cli\u003eForsberg S, H\u0026ouml;jer J, Enander C, et al. Coma and impaired consciousness in the emergency room: characteristics of poisoning versus other causes. \u003cem\u003eEmerg Med J\u003c/em\u003e 2009;26(2):100-02.\u003c/li\u003e\n\u003cli\u003eKuo S-C, Lin C-N, Lin Y-J, et al. Optimal intervals of ultrasonography screening for early diagnosis of hepatocellular carcinoma in Taiwan. \u003cem\u003eJAMA network open\u003c/em\u003e 2021;4(6):e2114680-e80.\u003c/li\u003e\n\u003cli\u003eBraun M, Schmidt WU, M\u0026ouml;ckel M, et al. Coma of unknown origin in the emergency department: implementation of an in-house management routine. \u003cem\u003eScand J Trauma Resusc Emerg Med\u003c/em\u003e 2016;24:61. doi: 10.1186/s13049-016-0250-3 [published Online First: 2016/04/29]\u003c/li\u003e\n\u003cli\u003eXiao H-y, Wang Y-x, Teng-da Xu H-dZ, et al. Evaluation and treatment of altered mental status patients in the emergency department: Life in the fast lane. \u003cem\u003eWorld J Emerg Med\u003c/em\u003e 2012;3(4):270.\u003c/li\u003e\n\u003cli\u003eSchmidt WU, Ploner CJ, Lutz M, et al. Causes of brain dysfunction in acute coma: a cohort study of 1027 patients in the emergency department. \u003cem\u003eScand J Trauma Resusc Emerg Med\u003c/em\u003e 2019;27(1):101. doi: 10.1186/s13049-019-0669-4\u003c/li\u003e\n\u003cli\u003eAmorim RL, Nagumo MM, Paiva WS, et al. Current clinical approach to patients with disorders of consciousness. \u003cem\u003eRev Assoc Med Bras\u003c/em\u003e 2016;62(4):377-84. doi: 10.1590/1806-9282.62.04.377\u003c/li\u003e\n\u003cli\u003eBaron-Esquivias G, Martinez-Alday J, Martin A, et al. Epidemiological characteristics and diagnostic approach in patients admitted to the emergency room for transient loss of consciousness: Group for Syncope Study in the Emergency Room (GESINUR) study. \u003cem\u003eEuropace\u003c/em\u003e 2010;12(6):869-76. doi: 10.1093/europace/euq018\u003c/li\u003e\n\u003cli\u003eLucca LF, Lofaro D, Pignolo L, et al. Outcome prediction in disorders of consciousness: the role of coma recovery scale revised. \u003cem\u003eBMC Neurol\u003c/em\u003e 2019;19(1):68. doi: 10.1186/s12883-019-1293-7 [published Online First: 2019/04/20]\u003c/li\u003e\n\u003cli\u003eHamel MB, Goldman L, Teno J, et al. Identification of comatose patients at high risk for death or severe disability. \u003cem\u003eJAMA\u003c/em\u003e 1995;273(23):1842-48.\u003c/li\u003e\n\u003cli\u003eSkinner HG, Blanchard J, Elixhauser A. Trends in Emergency Department Visits, 2006\u0026ndash;2011: Statistical Brief #179: Agency for Healthcare Research and Quality (US), Rockville (MD) 2006.\u003c/li\u003e\n\u003cli\u003eKanich W, Brady WJ, Huff JS, et al. Altered mental status: evaluation and etiology in the ED. \u003cem\u003eThe American journal of emergency medicine\u003c/em\u003e 2002;20(7):613-17.\u003c/li\u003e\n\u003cli\u003eSkinner HG, Blanchard J, Elixhauser A. Trends in emergency department visits, 2006\u0026ndash;2011: statistical brief# 179. 2014\u003c/li\u003e\n\u003cli\u003eCai CX, Michalak SM, Stinnett SS, et al. Effect of ICD-9 to ICD-10 Transition on Accuracy of Codes for Stage of Diabetic Retinopathy and Related Complications: Results from the CODER Study. \u003cem\u003eOphthalmol Retina\u003c/em\u003e 2021;5(4):374-80. doi: 10.1016/j.oret.2020.08.004 [published Online First: 20200815]\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Coma, Clinical Classifications Software, Incidence, Risk factors, Natural history studies, Prognosis","lastPublishedDoi":"10.21203/rs.3.rs-4697186/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4697186/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjectives\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo investigate the clinical nature of acute coma, which will serve as a reference for subsequent clinical decision-making\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods and analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis observational study utilized Taiwan National Health Insurance Database to identify cases of acute coma from 2000 to 2017 based on ED discharge diagnoses. Clinical Classification Software (CCS) was employed to categorize the causes of acute coma. We examined the characteristics of acute coma cases, age-specific incidence rates, underlying causes, and clinical outcomes such as reversible coma, hospitalization, and 30-day mortality. Additionally, we assessed functional outcomes at a one-year follow-up. Long-term factors influencing mortality were ascertained using Cox regression.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong 99,217,322 ED visits between 2000 and 2017, 419,480 acute coma events were identified, with an event rate of 4.23 per 1,000 ED visits and an incidence rate of 0.93 per 1,000 person-years. We analyzed 205,747 first-ever acute coma cases, predominantly male (58.90%), aged 58.27 years (SD 23.04). Infection and CNS causes were predominant. CNS and drug-related causes contributed to increased 30-day mortality, while psychiatric, alcohol, women's health and perinatal care, and seizure are causes linked to reversible coma. Patients needed intensive care (26.54%), life-sustaining treatments (41.09%), or disability (6.57%). Generalized estimating equations revealed that CNS (aOR, 0.68; 95% CI, 0.62 to 0.74; p \u0026lt; .0001) and drug-related causes (aOR, 0.72; 95% CI, 0.65 to 0.81; p \u0026lt; .0001) were less likely to result in reversible coma, suggesting higher 30-day mortality risk factors. Cox regression showed drugs (aHR, 1.30, 95% CI 1.20 to 1.41, p \u0026lt; .001), neoplasm (aHR, 1.18, 95% CI 1.11 to 1.25, p \u0026lt; .001), and symptoms (aHR, 1.44, 95% CI 1.24 to 1.67, p \u0026lt; .001) elevated the long-term death risk.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOur study demonstrates the use of ICD codes aggregation to CCS in acute coma clinical study, providing insights into its clinical nature.\u003c/p\u003e","manuscriptTitle":"Incidence, Etiology, and Clinical Outcomes of Acute Coma","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-08-09 21:30:53","doi":"10.21203/rs.3.rs-4697186/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4515a87e-1924-4804-b8ad-ce9bb8297d48","owner":[],"postedDate":"August 9th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-11-25T20:23:31+00:00","versionOfRecord":[],"versionCreatedAt":"2024-08-09 21:30:53","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4697186","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4697186","identity":"rs-4697186","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}