Etiology and Outcome of Non-traumatic Coma

Abstract

Abstract: Non-traumatic coma is a result of heterogeneous group of diseases and is an important cause of morbidity and mortality in children. Local data is scarce on epidemiology. Literature on pediatric non-traumatic coma is rather inconclusive, as there are a few systematic studies, and most of them are retrospective.
Objectives: The Purpose of this study was to determine the specific age group, etiology and outcome of non-traumatic coma in children.
Materials and Methods: In an observational study over a period of 6 months from 1st July 2010 to 31 December 2010, files of 111 children aged between 1 month – 16 years admitted with non-traumatic coma GCS (Glasgow Coma Scale of < 12/15 with at least 6 hrs. duration) to the emergency section of Pediatrics Department of Jinnah Hospital Lahore were reviewed. Data was collected from the files and entered using SPSS version 16. Chi-square and P value were calculated. Etiology was determined from history, physical examination and relevant investiga-tion. Outcome was grouped as died or discharged (with normal neurological examination with mild to moderate disability or vegetative state / severe neurological disability), left against medical advice or referred.
Results: Etiology was infectious in 66 (60%) patients, accidents / intoxication in 13 (11.4%) patients, epilepsy (status epileptics) in 12 (10.8%) patients, encephalopathy in 8 (7%) cases, metabolic (diabetic ketoacidosis, inborn error of metabolism) in 5 (4.50%) patients. Overall mortality was in 29 (26.12%). Mortality was high in infants 53.12% as compared to other age groups.
Conclusion: The most common cause of non-traumatic coma in children was Central Nervous System infections. Mortality was high in infants.