Current topic: Incidence, aetiology, and outcome of non-traumatic coma: a population based study

Abstract

Aim-To determine the incidence, presentation, aetiology, and outcome of nontraumatic 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%.

Acute Febrile Encephalopathy in Children and Predictors of Mortality

“…In our study, we found higher mortality in females (16, 22.55%) and it was similar to previous studies [4,11]. However, Khodapanahandeh F et al, [8] and Wong CP et al, [10] found no sex difference in mortality.…”

“…This difference in mortality can be explained by the difference in aetiology, and diagnostic and treatment facilities. Similar to a study from Iran [8] and Wong CP et al, [10], we found higher mortality in age group of one month to 3y (15, 40.55%). In our study, we found higher mortality in females (16, 22.55%) and it was similar to previous studies [4,11].…”

Clinical Profile of Children with Acute Febrile Encephalopathy in a Tertiary Health Care Center of Nepal

“…Wong et al has es mated the incidence of nontrauma c coma to be 30/100,000 children in the Northern region of England 6 . The incidence of acute febrile encephalopathy in this hospital was 5.50% which is similar to another study done in eastern Nepal where the incidence was noted to be 6.2%, however a much higher incidence of 10-15% was noted in India 9,10 58 had JE.…”

“…Outcome of such illness may range from complete recovery through varying degrees of neurological disability to death from either acute ilness or complica ons. A be er understanding of the causes and outcomes of this heterogeneous group of children will aid the design of protocols for their inves ga on and management 6 .…”

“…Similarly malnutri on and anemia which are rampant in developing countries have been known to be a signifi cant contribu ng factor to mortality in these pa ents 8 . Proper data on incidence, severity, and outcome are a prerequisite for informed provision of health-care resources for this group 6 . Very limited work has been done to know the actual burden of the diff erent neurological disease in Nepalese children 7 .…”