The primary goal of this study is to determine trends of incidence of coma and the financial burden of hospitalizations related to coma.

Coma is associated with several poor outcomes, including increased mortality and increased patient charges by up to 39%.

This is a cross-sectional cohort study of inpatient subjects from 2016-2019 with a primary diagnosis of coma collected from the Agency for Healthcare Research and Quality (AHRQ) via the Healthcare Cost and Utilization Project (HCUP). Patients were evaluated for demographics, hospital length of stay and charges, and aggregated charges.

During the study period, we reviewed 23,810 discharges with principal diagnosis of coma, with a mean incidence of coma of 1.825[+/- 0.1] in 100,000 population. The absolute number of total coma patients declined during the period from 6,515 to 5,445 per year (p = 0.00), and the mean rate of discharge for coma patients declined from 2 [+/- 0.1] to 1.7 [+/- 0.1] in 100,000 population (p = 0.03), with mean total coma discharges of 5,925 [+/- 232] per year. The mean length of stay for coma patients was 10.43 [ +/- 0.69] days, with mean mortality of 35.65% [+/-1.65].

When analyzing financial aspects of these patients, the mean charges for each coma patient was $97,880 [+/- 6,095]. During the period, the U.S. spent 550 million dollars on hospitalized coma patients each year totaling over 2.3 billion dollars.

Our data demonstrate while the incidence of coma is relatively low in the general population, the mortality rate approaches one in three patients. Additionally, the financial burden of coma on the U.S. healthcare budget was over 2 billion dollars during the four-year period creating a significant burden on the healthcare economy. Further studies are necessary to identify a standardized approach to diagnosis/management to minimize expenses and identify risk factors which influence mortality.