What is it about?
Impaired consciousness is a life-threatening condition that frequently requires intensive care unit (ICU) admission. In Benin, no study had previously examined survival outcomes in this population. This retrospective cohort study, conducted at the Centre National Hospitalier Universitaire Hubert K. Maga (CNHU-HKM), the national referral hospital of Benin, found that 67.1% of patients died in the ICU, with a median time to death of five days. Older age, low Glasgow Coma Scale score, low systolic blood pressure, high body temperature, absence of traumatic brain injury, and absence of oxygen therapy were associated with higher mortality. These findings support early risk stratification using simple clinical parameters available at admission.
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Why is it important?
In sub-Saharan Africa, data on ICU outcomes among critically ill patients with impaired consciousness remain scarce, particularly in low-resource settings. This study is the first to specifically examine survival outcomes in this population in Benin. By identifying simple clinical parameters associated with ICU mortality, it provides actionable evidence for early risk stratification in settings where severity scores such as APACHE II or SOFA are often unavailable. It also demonstrates that robust estimates can be generated from real-world data using rigorous survival analysis methods, offering a replicable framework for similar resource-limited settings across the region.
Perspectives
During our training in general medicine in Benin, there was a shared observation among all medical students of the time: when a patient was admitted to the intensive care unit, their chances of survival were perceived as low. This study was born out of that observation — and out of the conviction that such perceptions, however widely shared, need to be examined with data. I hope it contributes, even modestly, to improving critical care in Benin and across sub-Saharan Africa, and that it encourages other researchers in low-resource settings to generate the evidence their clinical contexts need.
Dr. Mahunan Gerard Sossou
Universite d'Abomey-Calavi
Read the Original
This page is a summary of: Survival and factors associated with intensive care unit mortality among adults with impaired consciousness in Benin, a low-resource setting: A retrospective cohort study, PLOS One, June 2026, PLOS,
DOI: 10.1371/journal.pone.0350120.
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