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1.
Indian J Pediatr ; 2005 Apr; 72(4): 293-5
Artículo en Inglés | IMSEAR | ID: sea-83233

RESUMEN

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. METHOD: 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. CONCLUSION: 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.


Asunto(s)
Enfermedad Aguda , Tronco Encefálico/fisiología , Niño , Coma/diagnóstico , Femenino , Estudios de Seguimiento , Escala de Coma de Glasgow , Humanos , Masculino , Evaluación de Resultado en la Atención de Salud , Guías de Práctica Clínica como Asunto , Valor Predictivo de las Pruebas , Pronóstico , Reflejo/fisiología , Análisis de Regresión , Factores de Tiempo , Conducta Verbal
2.
Indian Pediatr ; 2003 Jul; 40(7): 620-5
Artículo en Inglés | IMSEAR | ID: sea-15212

RESUMEN

OBJECTIVE: To assess the relationship between Modified Glasgow Coma Scale (MGCS), its components and survival in children with acute coma. DESIGN: Prospective observational study. SETTING: Tertiary care referral hospital. PATIENTS: Consecutive children (n = 270) with acute nontraumatic coma between 2 months to 12 years. METHODOLOGY: 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. MAIN OUTCOME MEASURE: 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. CONCLUSION: A score incorporating the brain stem reflexes, ocular response and motor response in the assessment and prognostication of comatose patients needs to be evaluated.


Asunto(s)
Niño , Preescolar , Coma/mortalidad , Femenino , Escala de Coma de Glasgow , Humanos , Lactante , Masculino , Evaluación de Resultado en la Atención de Salud , Valor Predictivo de las Pruebas
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