Tallat Seyal, Tariq Bhatti, Mohammad Shahid, Sidra Seyal.
Etiology and Outcome of Non-traumatic Coma.
Pak J Neuro Surg Jan ;16(1):27-30.

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 investigation. 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.

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