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        While the mortality rate for those who develop hemiplegia (loss of function of one half of body) is two per cent, it is 41 per cent for patients suffering from drowsiness along with hemiplegia.

        Deeper the coma, higher is the mortality rate for those diagnosed with hemiplegia, according to Dr R S Hariharan, director, Diabetes and Heart Care Hospital Pvt Ltd at Nanganallur. Coma due to haemorrhage (bleeding) carries a worse prognosis than that due to a block in the blood vessels.

        Among those admitted in comatose state due to stroke, 25 per cent die within 24 hours, 50 per cent within 3 days, 65 per cent within 7 days and 75 per cent within 21 days. Longer the duration of coma, greater is the mortality rate. When coma lasts for less than 24 hours, 44 per cent die within four weeks. When it lasts for 48 hours, the mortality rate is 86 per cent and if coma extends to 48 hours, 95 per cent of the affected die.

        A stroke patient in coma for more than six hours has essentially no chance of making a recovery and many doctors with such patients will just keep managing the blood circulation to optimum level for prolonging life. The doctors will also focus on the maintenance of respiratory functions, oxygenation, blood sugar level, body nutrition and taking care of the skin, eyes, bladder and bowel, apart from taking measures to reduce the swelling in the brain.

        What is the outcome following coma due to stroke? Dr Hariharan, a former professor and head, Department of Diabetology, Madras Medical College and Government General Hospital, says in order to forecast the outcome following coma due to stroke, it is necessary to understand the various grades of recovery following coma. These grades are based on the four important factors: Is the patient capable of regaining normal function, or, if he was already disabled before the present stroke, is he capable of regaining the previous level of activity? Will he be physically independent to look after himself? Will he recover the ability to understand the world around him? Will he regain consciousness and be awake?

        Accordingly, the five grades of outcome are possible:

        Good recovery: The patient will regain at least previous level of activity. Totally independent, he will be conscious and understanding.

        Moderate recovery: The patient will not regain full level of activity as before, but otherwise he will be all right.

        Severe disability: He will have severe limitation in activity and be physically dependent for daily chores.

        Vegetative state: He will be awake, but totally dependent and may not be able to even understand happenings around him.

        No recovery: The patient will remain in coma till death.

        Recovery chances

        Here are the percentages for good recovery at the end of one month for patients admitted in coma due to a stroke: Of all those admitted in coma stage only 15 per cent make good recovery; of those surviving at the end of 24 hours, 20 per cent make good recovery; among those who had survived in the first three days, 25 per cent make good recovery and finally, among those who had survived for seven days, 35 per cent make good recovery.