Long-term outcome in coma.
OBJECTIVE
To assess the relationship between Modified Glasgow Coma Scale, its components, brain stem reflexes and long term functional outcome in children with acute non-traumatic coma.


METHODS
MGCS and brainstem reflexes were assessed at 6 hourly intervals for 72 hours from the time of admission. The children were followed up regularly and functional outcome was assessed at the end of 9 months. The lowest score of the MGCS and worst brain stem reflexes were used for the analysis.


RESULTS
Higher total MGCS score and verbal response score had a significant positive correlation with better functional outcome as measured by GOS and intelligence quotient. There was no association between the language function and the initial MGCS, its components and brain stem reflexes. Lower verbal response (P = 0.005) was the only factor that was found to be individually associated with poorer long term GOS score and intelligence quotient by multivariate linear regression analysis.


CONCLUSIONS
In the long term prediction of outcome in acute non-traumatic coma, MGCS is not useful. However, verbal response, a component of MGCS, correlates well with long term functional outcome and intelligence quotient.
Nayana
Prabha P
PP
Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Dhanvantri Nagar, Pondicherry, India.
Serane
Tiroumourougane V
TV
Nalini
P
P
Mahadevan
S
S
D000208:Acute Disease; D001933:Brain Stem / Q000502:physiology; D002648:Child; D003128:Coma / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D011379:Prognosis; D012018:Reflex / Q000502:physiology; D012044:Regression Analysis; D013997:Time Factors; D014705:Verbal Behavior