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

Aim-To determine the incidence, presentation, aetiology, and outcome of non -traumatic 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 ho spital admission or community death associated with non-traumatic coma. Com a 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 u nder 16 per year (6.0 per 100 000 general population per year). The age spe cific incidence was notably higher in the first year of life (160 per 100 0 00 children per year). CNS specific presentations became commoner with incr easing age. In infants, nearly two thirds of presentations were with non-sp ecific, systemic signs. Infection was the commonest overall aetiology. Aeti ology remained unknown in 14% despite extensive investigation and/or autops y. Mortality was highly dependent on aetiology, with aetiology specific mor tality rates varying from 3% to 84%. With follow up to approximately 12 mon ths, overall series mortality was 46%.