Published in PLOS One on 2026-06-24, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Mahunan Gerard Sossou, Dieu donne Gnonlonfoun, Nik Hisamuddin Nik Ab Rahman
Source: PLOS One • DOI 10.1371/journal.pone.0350120
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Impaired consciousness is a common and potentially life-threatening condition that frequently requires admission to intensive care units (ICUs). In sub-Saharan Africa, data on outcomes among critically ill patients with impaired consciousness remain limited, particularly in resource-limited settings. This study aimed to estimate survival and identify factors associated with ICU mortality among adults with impaired consciousness admitted to the ICU of the national referral hospital in Benin.
This single-center retrospective cohort study used secondary data from the ICU database covering January 2015 to June 2017. Survival was estimated using the Kaplan–Meier method, and factors associated with ICU mortality were identified using Cox proportional hazards models.
Among 416 patients, 279 died, yielding an ICU mortality of 67.1%. The median time to death in the ICU was 5 days. Survival probabilities declined from 77.6% on day 1 to 21.9% on day 15 and 13.7% on day 30. In multivariable analysis, older age and lower Glasgow Coma Scale score showed time-varying associations with ICU mortality. Lower systolic blood pressure, higher body temperature, absence of traumatic brain injury, and absence of oxygen therapy were independently associated with higher ICU mortality.
ICU mortality among adults with impaired consciousness admitted to this ICU was very high. This observation is consistent with constraints in essential critical care resources. Simple clinical parameters available at admission may support early risk stratification. Strengthening essential critical care components, particularly basic physiological monitoring and reliable oxygen supply, warrants consideration in sub-Saharan African ICUs.
Introduction
Impaired consciousness is a common and potentially life-threatening clinical condition that frequently requires admission to emergency departments (EDs) or intensive care units (ICUs). Approximately 4% to 10% of ED patients present with impaired consciousness, and many require ICU admission due to illness severity or the need for close monitoring and supportive care [1,2].
In sub-Saharan Africa, evidence on the epidemiology and outcomes of impaired consciousness in critically ill patients remains limited. This gap is particularly relevant in low- and middle-income countries (LMICs), where ICU capacity is often constrained and ICU mortality among critically ill patients remains high [3–5]. Context-specific prognostic data are therefore essential for triage and early clinical decision-making in resource-limited settings. A White Paper jointly supported by the International Federation for Emergency Medicine and the World Federation of Intensive and Critical Care Medicine has also highlighted this need [6].
In Benin, to our knowledge, no study has specifically examined survival outcomes among adults with impaired consciousness admitted to the ICU. A better understanding of factors associated with ICU mortality is needed to guide triage, early management, and resource allocation. This study therefore aimed to estimate survival and identify factors associated with ICU mortality among adults with impaired consciousness admitted to the ICU of the national referral hospital in Benin.
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider hospital systems desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Mahunan Gerard Sossou, Dieu donne Gnonlonfoun, Nik Hisamuddin Nik Ab Rahman. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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