Role of Glasgow Coma Scale in pediatric nontraumatic coma.
OBJECTIVE
To assess the relationship between Modified Glasgow Coma Scale (MGCS), its components and survival in children with acute coma.


METHODS
Prospective observational study.


METHODS
Tertiary care referral hospital.


METHODS
Consecutive children (n = 270) with acute nontraumatic coma between 2 months to 12 years.


METHODS
MGCS and brainstem reflexes were assessed at 6 hourly intervals for 72 hours from the time of admission. The lowest score of the MGCS and worst brain stem reflexes were used for the analysis.


METHODS
Survival.


RESULTS
Total score (Spearman rank correlation coefficient IRI = O.577, ocular response (IRI = O.641), motor response (IRI = O.729), verbal response (lRI = 0.608), brain stem response (lRI = O.843) were all found to be associated with adverse outcome. Multivariate regression analysis revealed that ocular response and motor response were individually predictive of short-term outcome.


CONCLUSIONS
A score incorporating the brain stem reflexes, ocular response and motor response in the assessment and prognostication of comatose patients needs to be evaluated.
Nayana Prabha
P C
PC
Department of Pediatrics, Jawaharalal Institute of Postgraduate Medical Education and Research, Dhanvantri Nagar, Pondicherry 605 006, India. drnayanap@yahoo.com
Nalini
P
P
Tiroumourougane Serane
V
V
D002648:Child; D002675:Child, Preschool; D003128:Coma / Q000401:mortality*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D008297:Male; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests