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Incidence, aetiology, and outcome of non-traumatic coma: a
population based study
C P Wong, R J Forsyth, T P Kelly, J A Eyre
Paediatric
Neuroscience Group, Department of Child Health, University of
Newcastle-upon-Tyne, Newcastle-upon-Tyne NE1 4LP, UK
Correspondence to: Dr Forsyth r.j.forsyth{at}newcastle.ac.uk
Accepted 17 May 2000
AIM
To determine the incidence,
presentation, aetiology, and outcome of non-traumatic coma in children
aged between 1 month and 16 years.
METHODSIn this prospective,
population based, epidemiological study in the former Northern NHS
region of the UK, cases were notified following any hospital admission
or community death associated with non-traumatic coma. Coma was defined
as a Glasgow Coma Score below 12 for more than six hours.
RESULTSThe incidence of
non-traumatic coma was 30.8 per 100 000 children under 16 per year
(6.0 per 100 000 general population per year). The age specific
incidence was notably higher in the first year of life (160 per
100 000 children per year). CNS specific presentations became commoner
with increasing age. In infants, nearly two thirds of presentations
were with non-specific, systemic signs. Infection was the commonest
overall aetiology. Aetiology remained unknown in 14% despite extensive
investigation and/or autopsy. Mortality was highly dependent on
aetiology, with aetiology specific mortality rates varying from 3% to
84%. With follow up to approximately 12 months, overall series
mortality was 46%.
Keywords: coma; epidemiology; prognosis; epilepsy; meningitis; encephalitis
© 2001 by Archives of Disease in Childhood
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