ATTEMPT TO ESTABLISH A CLASSIFICATION OF PATIENTS SUFFERING FROM COMAAND ADMITTED TO A HOSPITAL STRUCTURE FOR SHORT OR MEDIUM-TERM TREATMENT - MEDICAL ASPECTS AND COSTS OF HOSPITAL-CARE

We dispose of a database, constituted between 1987 and 1993, containin g medical and cost information concerning 515 patients suffering from coma and admitted, after a period of resuscitation, to a French hospit al establishment - Etablissement Helio-Marin of Berck-sur-Mer (EHMB) - for short and medium term treatment, between 1974 and 1986. From this base, which contains demographic and clinical data (age, sex, conditi on upon admission, duration of consciousness disorders, Glasgow Outcom e Scale (GOS) upon discharge) we devised a hierarchical classification analysis following a factorial analysis of multiple correspondences, on 2 sets: a sample of 515 patients (all causes of coma being merged) and a sample of 266 patients suffering from brain injuries. Four group s were determined for each typology. These groups were first described on the basis of the variables used for their construction, and later by considering other available variables : origin of coma, duration of stay at EHMB, future evolution of patients and cost of treatment (cos t of specific care, average daily cost, total cost of hospitalization) . Thus, typical clinical situations were identified in each classifica tion, depending on age of patient, origin of coma and condition upon a dmission. These situations led to extremely different treatment costs (ratio from 1 to 5 in the general typology and 1 to 2.85 in the classi fication of brain injuries).