Non traumatic coma.

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dc.contributor.authorBansal, Arunen_US
dc.contributor.authorSinghi, Sunit Cen_US
dc.contributor.authorSinghi, Pratibha Den_US
dc.contributor.authorKhandelwal, Nen_US
dc.contributor.authorRamesh, Sen_US
dc.date.accessioned2005-06-30en_US
dc.date.accessioned2009-05-30T15:46:40Z
dc.date.available2005-06-30en_US
dc.date.available2009-05-30T15:46:40Z
dc.date.issued2005-06-30en_US
dc.description.abstractOBJECTIVE: To study the etiology and clinical profile of non-traumatic coma in children and to determine the clinical signs predictive of outcome. METHODS: 100 consecutive cases of non-traumatic coma between 2 months to 12 years. Clinical signs studied were temperature, pulse, heart rate, blood pressure, coma severity by Glasgow coma scale (GCS), respiratory pattern, pupillary and corneal reflex, extra ocular movements, motor patterns, seizure types and fundus picture. These were recoded at admission and after 48 hours of hospital stay. Etiology of coma was determined on basis of clinical history, examination and relevant laboratory investigations by the treating physician. The outcome was recorded as survived or died, and among those who survived as normal, mild, moderate, or severe disability. Chi-square test and logistic regression analysis were done to determine predictors of outcome. RESULTS: Etiology of coma in 60% cases was CNS infection (tubercular meningitis-19, encephalitis-18, bacterial meningitis-16, others-7); other causes were toxic-metabolic conditions (19%), status epilepticus (10%), intracranial bleed (7%), and miscellaneous (4%). 65 children survived, 11 were normal, 14 had mild disability, 21 had moderate disability and 14 were severely disabled and dependent. Survival was significantly better in patients with CNS infection (63%) as compared to those with toxic-metabolic causes (27%) and intracranial bleed (43%, P < 0.05). On bivariate analysis age < or = 3 years, poor pulse volume, abnormal respiratory pattern and apnoea, abnormal pupillary size and reaction, abnormal extra ocular movements, absent corneal reflex, abnormal motor muscle tone at admission or 48 hours correlated significantly with mortality. Survival was better with increasing GCS (Spearman rho = .32, P < 0.001). On logistic regression age < 3 years, poor pulse volume, absent extraocular movements and papilloedema at admission and 48 hours after admission were independent significant predictors of death. CONCLUSION: CNS infections were the most common cause of non-traumatic coma in childhood. Simple clinical signs were good predictors of outcome.en_US
dc.description.affiliationDepartment of Pediatrics, Advanced Pediatrics Center, Post Graduate Institute of Medical Education and Research Center, Chandigarh, India.en_US
dc.identifier.citationBansal A, Singhi SC, Singhi PD, Khandelwal N, Ramesh S. Non traumatic coma. Indian Journal of Pediatrics. 2005 Jun; 72(6): 467-73en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/83941
dc.language.isoengen_US
dc.source.urihttps://medind.nic.in/icb/icbai.shtmlen_US
dc.subject.meshChilden_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshComa --diagnosisen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshInfanten_US
dc.subject.meshMaleen_US
dc.subject.meshPrognosisen_US
dc.subject.meshProspective Studiesen_US
dc.titleNon traumatic coma.en_US
dc.typeJournal Articleen_US
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