Value of coma scale in prediction of outcome in non-traumatic coma in 1-12 years old children

2021 ◽  
Vol 20 (1) ◽  
pp. 09-13
Author(s):  
Stalin Ramprakash ◽  
Keyword(s):  
Prediction Of Outcome ◽  
Coma Scale ◽  
Traumatic Coma

Value of coma scale in prediction of mortality in non-traumatic coma in 1-12 years old children

2021 ◽  
Vol 19 (3) ◽  
pp. 63-66
Author(s):  
Stalin Ramprakash ◽  
Keyword(s):  
Hospital Admissions ◽  
P Value ◽  
Good Recovery ◽  
Chi Square ◽  
Coma Scale ◽  
Time Points ◽  
Prediction Of Mortality ◽  
Traumatic Coma ◽  
Medical Wards ◽  
Observed Score

Background: Acute non-traumatic coma is a common problem in pediatric practice accounting for 10-15% of all hospital admissions and is associated with significant mortality. Assessment of the severity of coma is essential to comment on the likelihood of survival in comatose children. In the last three decades, various scores have been used to assess the severity of coma and to predict its outcome. Glasgow Coma Scale (MGCS) in spite of its various drawbacks has been widely used for assessing pediatric coma, though only few studies are available to support its use in pediatric coma as a whole. Hence the study was undertaken to evaluate the usefulness of coma scale in prediction of mortality in children between 1-12 years old admitted with coma of non-traumatic origin. Methods: A prospective study was conducted at Inpatient services of intensive medical care unit and general medical wards of Institute of child Health and Hospital for children, Egmore, Chennai, between October 2018 to November 2019. A Study Population consisting of children in the age group 1-12 years admitted in intensive care unit and medical wards with alteration in sensorium as one of the predominant complaints and admitted within 7 days of onset of coma were included. Sample size was 148. Chi-square test was used to study the association between the scores at Various times points and outcome. Results: It was observed that when the scores were between 3‐ 5 mortality rate was 67.0%, it was 17% when the minimal observed score was between 6-8. The group in which the minimal score never decreased be1ow 9 had no mortality. As the score increases the proportion of death decreases and the proportion having good recovery increases and vice versa. This type of association has been observed at different time points (Initial, 24 hrs, 48 hrs and 72 hrs). The significance of this association increases with the progression of time since admission. P value for the degree of association at various time points are: At presentation P < 0.00001, 24hrs - P < 0.000001, 48 hrs - P < 0.000001 and 72 hrs P < 0.00000001. Conclusion: There is highly statistically significant association between the GSC score levels and outcome. As the score increases the proportion of death decreases and the proportion having good recovery increases and vice versa.

scholarly journals Correlation of risk factors with Glasgow coma scale to predict the severity and outcome of children with non-traumatic coma

2019 ◽  
Vol 6 (4) ◽  
pp. 1524
Author(s):  
A. Manikanteswara Reddy ◽  
G. Sreedhar ◽  
Gangadhar B. Belavadi
Keyword(s):  
Glasgow Coma Scale ◽  
Hospital Admissions ◽  
Good Prognosis ◽  
Cns Infection ◽  
Coma Scale ◽  
The Family ◽  
Probability Of Death ◽  
Traumatic Coma ◽  
Gcs Score

Background: Non-traumatic coma is the problem of pediatric group, accounts 10-15% in hospital admissions. Assessment of the severity of coma is useful to speculate the survival. The aim was to assess outcome in pediatric non-traumatic coma with role of Glasgow coma scale and modified Glasgow coma scale.Methods: Total of 80 cases of non-traumatic coma between 1 month to 12 years, coma severity was assessed by using Glasgow coma scale. A score of less than 8 and more than 8 were used for analysis of outcome.Results: The maximum number of patents with non-traumatic coma were in the age group of 1 month-5 years, 40 children (50%). On neurological examination 42 (52.5%) children has GCS score of >8, 38 cases (47.5%) has GCS <8, 20 children had meningeal signs, 7 children had cranial nerve deficit (7th nerve), 9 children had decebrate posture. Out of 80 cases, 8 cases expired (10%), 4 cases were discharged against medical advice (4%), 68 cases were improved and discharged (85%), among these, 8 cases were discharged with complication (11.7%). Overall mortality was (10%) (8/80), males outnumbered females in frequency with ratio of 1.28:1. CNS infection accounted for almost about 66%.Conclusions: Children with GCS and MGCS scores of less than 8 have poor prognosis and a very high probability of death. Those with GCS score of more than 8 have good prognosis. Identification of these cases at the outset can help prepare the treating physician to plan critical care referral and to give a preliminary assessment of outcome to the family.

Glasgow Coma Scale in the Prediction of Outcome after Early Aneurysm Surgery

Neurosurgery ◽  
1996 ◽  
Vol 39 (1) ◽  
pp. 19-25 ◽  
Author(s):  
Osamu Gotoh ◽  
Akira Tamura ◽  
Nobuyuki Yasui ◽  
Akifumi Suzuki ◽  
Hiromu Hadeishi ◽  
...  
Keyword(s):  
Glasgow Coma Scale ◽  
Aneurysm Surgery ◽  
Prediction Of Outcome ◽  
Coma Scale ◽  
Early Aneurysm Surgery
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