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Long-term outcome in coma.

Prabha P Nayana1, Tiroumourougane V Serane, P Nalini

  • 1Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Dhanvantri Nagar, Pondicherry, India.

Indian Journal of Pediatrics
|May 7, 2005
PubMed
Summary
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The Modified Glasgow Coma Scale (MGCS) is not useful for predicting long-term outcomes in children with non-traumatic coma. However, the verbal response component of the MGCS strongly correlates with better functional outcomes and intelligence.

Area of Science:

  • Pediatric Neurology
  • Neurocritical Care

Background:

  • Acute non-traumatic coma in children presents diagnostic and prognostic challenges.
  • Accurate prediction of long-term functional outcome is crucial for patient management and rehabilitation.

Purpose of the Study:

  • To evaluate the predictive value of the Modified Glasgow Coma Scale (MGCS), its components, and brainstem reflexes for long-term functional outcomes in pediatric non-traumatic coma.
  • To identify specific clinical indicators that correlate with functional recovery and cognitive status.

Main Methods:

  • Children with acute non-traumatic coma were assessed using the MGCS and brainstem reflexes every 6 hours for 72 hours.
  • Functional outcome was evaluated at 9 months post-admission using the Glasgow Outcome Scale (GOS) and intelligence quotient (IQ).

Related Experiment Videos

  • Lowest MGCS scores and worst brainstem reflexes were analyzed, along with multivariate regression.

    • Main Results:

    • Higher total MGCS and verbal response scores showed a significant positive correlation with better GOS and IQ.
    • No association was found between language function and initial MGCS or brainstem reflexes.
    • Lower verbal response was the sole factor significantly associated with poorer long-term GOS and IQ in multivariate analysis.

    Conclusions:

    • The overall MGCS is not a reliable predictor of long-term outcomes in pediatric non-traumatic coma.
    • The verbal response component of the MGCS is a valuable predictor of long-term functional outcome and intelligence quotient in this patient population.