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Incidence, aetiology, and outcome of non-traumatic coma: a population based study
  1. C P Wong,
  2. R J Forsyth,
  3. T P Kelly,
  4. J A Eyre
  1. Paediatric Neuroscience Group, Department of Child Health, University of Newcastle-upon-Tyne, Newcastle-upon-Tyne NE1 4LP, UK
  1. Dr Forsythr.j.forsyth{at}newcastle.ac.uk

Abstract

AIM To determine the incidence, presentation, aetiology, and outcome of non-traumatic coma in children aged between 1 month and 16 years.

METHODS In 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.

RESULTS The 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%.

  • coma
  • epidemiology
  • prognosis
  • epilepsy
  • meningitis
  • encephalitis
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