Author:
ProCite
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Reference Manager
BibTeX
Zotero
EndNote
-
1.
Saper CB , Schiff N , Plum F , Posner JB , 2007. Plum and Posner’s Diagnosis of Stupor and Coma, 4th edition. New York, NY: Oxford University Press.
-
2.
Abend NS , Licht DJ , 2008. Predicting outcome in children with hypoxic ischemic encephalopathy. Pediatr Crit Care Med 9: 32–39.
-
3.
Nayana PP , Serane TV , Naline P , Mahadevan S , 2005. Long-term outcome in coma. Indian J Pediatr 72: 293–295.
-
4.
Bansal A , Singhi S , Singhi P , Khandelwal N , Ramesh S , 2005. Non-traumatic coma. Indian J Pediatr 72: 467–473.
-
5.
Wong CP , Forsyth RJ , Kelly TP , Eyre J , 2001. Incidence, etiology and outcome of non-traumatic coma: a population based study. Arch Dis Child 84: 193–199.
-
6.
Forsberg S , Hojer J , Ludwigs U , Nystrom H , 2012. Metabolic vs. structural coma in the ED - an observational study. Am J Emerg Med 30: 1986–1990.
-
7.
Huff JS , Stevens RD , Weingart SD , Smith WS , 2012. Emergency neurological life support: approach to the patient with coma. Neurocrit Care 17 (Suppl 1):S54–S59.
-
8.
Wijdicks EFM , 2019. C. Miller Fisher and the comatose patient. Neurocrit Care 30: 1–4.
-
9.
Abd El-Aziz FEZA , El Shehaby DM , Elghazally SA , Hetta HF , 2019. Toxicological and epidemiological studies of scorpion sting cases and morphological characterization of scorpions (Leiurusquin questriatus and Androctonus crassicauda) in Luxor, Egypt. Toxicol Rep 6: 329–335.
-
10.
Ghorbani A , Mansouri B , Baradaran M , 2021. Effects of climate variables on the incidence of scorpion stings in Iran for five years. J Venom Anim Toxins Incl Trop Dis 27: e20200110.
-
11.
Ludwig L , McWhirter L , Williams S , Derry C , Stone J , 2016. Functional coma. Handb Clin Neurol 139: 313–327.
-
12.
Grote S , Böcker W , Mutschler W , Bouillon B , Lefering R , 2011. Diagnostic value of the Glasgow Coma Scale for traumatic brain injury in 18,002 patients with severe multiple injuries. J Neurotrauma 28: 527–534.
-
13.
Chung CY , Chen CL , Cheng PT , See LC , Tang SF , Wong AM , 2006. Critical score of Glasgow Coma Scale for pediatric traumatic brain injury. Pediatr Neurol 34: 379–387.
-
14.
Tatman A , Warren A , Williams A , Powell JE , Whitehouse W , 1997. Development of a modified pediatric coma scale in intensive care clinical practice. Arch Dis Child 77: 519–521.
-
15.
Van de Voorde P , Sabbe M , Rizopoulos D , Tsonaka R , De Jaeger A , Lesaffre E , Peters M , 2008. PENTA study group assessing the level of consciousness in children: a plea for the Glasgow Coma Motor subscore. Resuscitation 76: 175–179.
-
16.
Takasawa K et al.2018. Cause of acute encephalitis/encephalopathy in Japanese children diagnosed by a rapid and comprehensive virological detection system and differences in their clinical presentations. Brain Dev 40: 107–115.
-
17.
World Health Organization , 1996. Vaccine Research and Development Generic Protocol for Population-Based Surveillance of Haemophilus Influenzae Type B. Geneva, Switzerland: WHO. Available at: https://apps.who.int/iris/handle/10665/64321.
-
18.
Guidelines for Epidemiologic Studies on Epilepsy , 1993. Commission on epidemiology and prognosis, international league against epilepsy. Epilepsia 34: 592–596.
-
19.
Jindal A , Singhi SC , Singhi P , 2012. Non-traumatic coma and altered mental status. Indian J Pediatr 79: 367–375.
-
20.
Satapathy D , Satpathy SK , 2018. Clinical profile and the outcome of children admitted to a tertiary care hospital with non-traumatic coma. J Pediatr Crit Care 5: 15–22.
-
21.
Duyu M , Altun ZK , Yildiz S , 2020. Non-traumatic coma in the pediatric intensive care unit: etiology, clinical characteristics and outcome. Turk J Med Sci 51: 214–223.
-
22.
Anık A , Tekgül H , Yılmaz S , Karapınar B , Kitiş Ö , Aktan G , Gökben G , 2020. The prognostic role of clinical, electroencephalographic and neuro-radiological parameters in predicting outcome in pediatric non-traumatic coma. Pamukkale Medical Journal 13: 509–518.
-
23.
Gwer S , Chacha C , Newton CR , Idro R , 2013. Childhood acute non-traumatic coma: aetiology and challenges in management in resource-poor countries of Africa and Asia. Paediatr Int Child Health 33: 129–138.
-
24.
Ahmed S , Ejaz K , Shamim MS , Salim MA , Khans MUR , 2011. Non-traumatic coma in paediatric patients: etiology and predictors of outcome. J Pak Med Assoc 61: 671–675.
-
25.
Khodapanahandeh F , Najarkalayee N , 2009. Etiology and outcome of non-traumatic coma in children admitted to pediatric intensive care unit. Iran J Pediatr 19: 393–398.
-
26.
Khajeh A , Miri-Aliabad G , Fayyazi A , 2015. Non-traumatic coma in children in south-east of Iran. J Compr Ped 6: e25049.
-
27.
Hmimou R , Soulaymani A , Mokhtari A , Arfaoui A , Eloufir G , Semlali I , Soulaymani BR , 2008. Risk factors caused by scorpion stings and envenomations in the province of Kelâa Des Sraghna (Morocco). J Venom Anim Toxins Incl Trop Dis 14: 628–640.
-
28.
Chelliah LR , Karthick AR , Theranirajan E , Gangadharan S , 2017. Clinical study of coma in children. J Med Sci Clin Res 5: 26054–26058.
-
29.
Khodapanahandeh F , Najarkalayee N , 2009. Etiology and outcome of non-traumatic coma in children admitted to pediatric intensive care unit. Iran J Pediatr 19: 393–398.
-
30.
Bosnak M , Levent Yilmaz H , Ece A , Yildizdas D , Yolbas I , Kocamaz H , Kaplan M , Bosnak V , 2009. Severe scorpion envenomation in children: management in pediatric intensive care unit. Hum Exp Toxicol 28: 721–728.
-
31.
Owolabi LF , Mohammed AD , Dalhat MM , Ibrahim A , Aliyu S , Owolabi DS , 2013. Factors associated with death and predictors of 1-month mortality in non-traumatic coma in a tertiary hospital in northwestern Nigeria. Indian J Crit Care Med 17: 219–223.
-
32.
Pankaj BM , Parmar P , Doshi SK , Chudasama RK , 2011. Outcome predictors of non-traumatic coma with infective etiology in children. J Pharm Biomed Sci 12: 1–5.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1999 | 289 | 23 |
| Full Text Views | 57 | 36 | 1 |
| PDF Downloads | 62 | 34 | 1 |
Clinico-Etiological Profile and Predictors of Mortality of Nontraumatic Coma in Children of Upper Egypt: A Prospective Observational Study
Khaled A. Abdel Baseer
Khaled A. Abdel Baseer
Department of Pediatrics, Qena Faculty of Medicine, South Valley University, Qena, Egypt;
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Ismail Lotfy Mohamad
Ismail Lotfy Mohamad
Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt;
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Heba M. Qubaisy
Heba M. Qubaisy
Department of Pediatrics, Qena Faculty of Medicine, South Valley University, Qena, Egypt;
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Magda F. Gabri
Magda F. Gabri
Department of Pediatrics, Faculty of Medicine, Aswan University, Aswan, Egypt;
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Mohamed A. A. Abdel Naser
Mohamed A. A. Abdel Naser
Department of Anesthesia and ICU, Faculty of Medicine, Assiut University, Assiut, Egypt
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Yaser F. Abdel Raheem
Yaser F. Abdel Raheem
Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt;
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ABSTRACT.
Nontraumatic coma (NTC) is a considerable cause of morbidity and mortality in children. This prospective observational study aimed to determine the clinico-etiological profile of NTC in children and delineate clinical signs predicting mortality in Upper Egypt from June 2019 to May 2020. All children from 1 month of age to 16 years who were admitted with NTC were included in the study. All patients received full histories and physical examinations, including Glasgow Coma Scale (GCS). Routine laboratory investigations including complete blood count, electrolytes, blood sugar, serum creatinine, and liver function tests were performed for all patients. Specific investigations such as metabolic studies, lumbar punctures, brain computed tomography scans, and magnetic resonance imaging were done when indicated. The precise etiology was determined and clinical presentations for survivors and nonsurvivors were compared. Among the 137 cases of NTC identified, central nervous system (CNS) infections were the most common cause leading to 38 cases, followed by toxic causes in 37 cases, status epilepticus in 22 cases, and metabolic causes in 21 cases. Hypothermia, hypotension, abnormal respiratory patterns, muscle hypotonia, absent corneal reflex, presence of shock, and need for mechanical ventilation were significantly correlating with mortality. The estimated mortality rate was 18.2% and all cases with GCS < 5 died. Toxic causes were the most commonly identified etiology in patients who died. In conclusion, the authors identified several etiologies for NTC in Upper Egypt and their corresponding clinical signs at presentation. This information can be used to improve the clinical care provided to children with NTC.
- Supplemental Materials (PDF 27 KB)
Author Notes
Authors’ addresses: Khaled A. Abdel Baseer, Department of Pediatrics, Qena Faculty of Medicine, South Valley University, Qena, Egypt, E-mail: khaledabdalla20@yahoo.com. Ismail Lotfy Mohamad, Department of Pediatrics, Faculty of Medicine, Assiut University, Asyut, Egypt, E-mail: ismail231@aun.edu.eg. Heba M. Qubaisy, Qena Faculty of Medicine, South Valley University, Qena, Egypt, E-mail: hebaqubasy@gmail.com. Magda F. Gabri, Department of Pediatrics, Faculty of Medicine, Aswan University, Aswan, Egypt, E-mail: magda.farghly@med.aswu.edu.eg. Mohamed A. A. Abdel Naser, Department of Anesthesia and ICU, Faculty of Medicine, Assiut University, Asyut, Egypt, E-mail: monbasser@yahoo.com. Yaser F. Abdel Raheem, Department of Pediatrics, Faculty of Medicine, Assiut University, Asyut, Egypt, E-mail: yasser.rezk@med.aun.edu.eg.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Saper CB , Schiff N , Plum F , Posner JB , 2007. Plum and Posner’s Diagnosis of Stupor and Coma, 4th edition. New York, NY: Oxford University Press.
-
2.
Abend NS , Licht DJ , 2008. Predicting outcome in children with hypoxic ischemic encephalopathy. Pediatr Crit Care Med 9: 32–39.
-
3.
Nayana PP , Serane TV , Naline P , Mahadevan S , 2005. Long-term outcome in coma. Indian J Pediatr 72: 293–295.
-
4.
Bansal A , Singhi S , Singhi P , Khandelwal N , Ramesh S , 2005. Non-traumatic coma. Indian J Pediatr 72: 467–473.
-
5.
Wong CP , Forsyth RJ , Kelly TP , Eyre J , 2001. Incidence, etiology and outcome of non-traumatic coma: a population based study. Arch Dis Child 84: 193–199.
-
6.
Forsberg S , Hojer J , Ludwigs U , Nystrom H , 2012. Metabolic vs. structural coma in the ED - an observational study. Am J Emerg Med 30: 1986–1990.
-
7.
Huff JS , Stevens RD , Weingart SD , Smith WS , 2012. Emergency neurological life support: approach to the patient with coma. Neurocrit Care 17 (Suppl 1):S54–S59.
-
8.
Wijdicks EFM , 2019. C. Miller Fisher and the comatose patient. Neurocrit Care 30: 1–4.
-
9.
Abd El-Aziz FEZA , El Shehaby DM , Elghazally SA , Hetta HF , 2019. Toxicological and epidemiological studies of scorpion sting cases and morphological characterization of scorpions (Leiurusquin questriatus and Androctonus crassicauda) in Luxor, Egypt. Toxicol Rep 6: 329–335.
-
10.
Ghorbani A , Mansouri B , Baradaran M , 2021. Effects of climate variables on the incidence of scorpion stings in Iran for five years. J Venom Anim Toxins Incl Trop Dis 27: e20200110.
-
11.
Ludwig L , McWhirter L , Williams S , Derry C , Stone J , 2016. Functional coma. Handb Clin Neurol 139: 313–327.
-
12.
Grote S , Böcker W , Mutschler W , Bouillon B , Lefering R , 2011. Diagnostic value of the Glasgow Coma Scale for traumatic brain injury in 18,002 patients with severe multiple injuries. J Neurotrauma 28: 527–534.
-
13.
Chung CY , Chen CL , Cheng PT , See LC , Tang SF , Wong AM , 2006. Critical score of Glasgow Coma Scale for pediatric traumatic brain injury. Pediatr Neurol 34: 379–387.
-
14.
Tatman A , Warren A , Williams A , Powell JE , Whitehouse W , 1997. Development of a modified pediatric coma scale in intensive care clinical practice. Arch Dis Child 77: 519–521.
-
15.
Van de Voorde P , Sabbe M , Rizopoulos D , Tsonaka R , De Jaeger A , Lesaffre E , Peters M , 2008. PENTA study group assessing the level of consciousness in children: a plea for the Glasgow Coma Motor subscore. Resuscitation 76: 175–179.
-
16.
Takasawa K et al.2018. Cause of acute encephalitis/encephalopathy in Japanese children diagnosed by a rapid and comprehensive virological detection system and differences in their clinical presentations. Brain Dev 40: 107–115.
-
17.
World Health Organization , 1996. Vaccine Research and Development Generic Protocol for Population-Based Surveillance of Haemophilus Influenzae Type B. Geneva, Switzerland: WHO. Available at: https://apps.who.int/iris/handle/10665/64321.
-
18.
Guidelines for Epidemiologic Studies on Epilepsy , 1993. Commission on epidemiology and prognosis, international league against epilepsy. Epilepsia 34: 592–596.
-
19.
Jindal A , Singhi SC , Singhi P , 2012. Non-traumatic coma and altered mental status. Indian J Pediatr 79: 367–375.
-
20.
Satapathy D , Satpathy SK , 2018. Clinical profile and the outcome of children admitted to a tertiary care hospital with non-traumatic coma. J Pediatr Crit Care 5: 15–22.
-
21.
Duyu M , Altun ZK , Yildiz S , 2020. Non-traumatic coma in the pediatric intensive care unit: etiology, clinical characteristics and outcome. Turk J Med Sci 51: 214–223.
-
22.
Anık A , Tekgül H , Yılmaz S , Karapınar B , Kitiş Ö , Aktan G , Gökben G , 2020. The prognostic role of clinical, electroencephalographic and neuro-radiological parameters in predicting outcome in pediatric non-traumatic coma. Pamukkale Medical Journal 13: 509–518.
-
23.
Gwer S , Chacha C , Newton CR , Idro R , 2013. Childhood acute non-traumatic coma: aetiology and challenges in management in resource-poor countries of Africa and Asia. Paediatr Int Child Health 33: 129–138.
-
24.
Ahmed S , Ejaz K , Shamim MS , Salim MA , Khans MUR , 2011. Non-traumatic coma in paediatric patients: etiology and predictors of outcome. J Pak Med Assoc 61: 671–675.
-
25.
Khodapanahandeh F , Najarkalayee N , 2009. Etiology and outcome of non-traumatic coma in children admitted to pediatric intensive care unit. Iran J Pediatr 19: 393–398.
-
26.
Khajeh A , Miri-Aliabad G , Fayyazi A , 2015. Non-traumatic coma in children in south-east of Iran. J Compr Ped 6: e25049.
-
27.
Hmimou R , Soulaymani A , Mokhtari A , Arfaoui A , Eloufir G , Semlali I , Soulaymani BR , 2008. Risk factors caused by scorpion stings and envenomations in the province of Kelâa Des Sraghna (Morocco). J Venom Anim Toxins Incl Trop Dis 14: 628–640.
-
28.
Chelliah LR , Karthick AR , Theranirajan E , Gangadharan S , 2017. Clinical study of coma in children. J Med Sci Clin Res 5: 26054–26058.
-
29.
Khodapanahandeh F , Najarkalayee N , 2009. Etiology and outcome of non-traumatic coma in children admitted to pediatric intensive care unit. Iran J Pediatr 19: 393–398.
-
30.
Bosnak M , Levent Yilmaz H , Ece A , Yildizdas D , Yolbas I , Kocamaz H , Kaplan M , Bosnak V , 2009. Severe scorpion envenomation in children: management in pediatric intensive care unit. Hum Exp Toxicol 28: 721–728.
-
31.
Owolabi LF , Mohammed AD , Dalhat MM , Ibrahim A , Aliyu S , Owolabi DS , 2013. Factors associated with death and predictors of 1-month mortality in non-traumatic coma in a tertiary hospital in northwestern Nigeria. Indian J Crit Care Med 17: 219–223.
-
32.
Pankaj BM , Parmar P , Doshi SK , Chudasama RK , 2011. Outcome predictors of non-traumatic coma with infective etiology in children. J Pharm Biomed Sci 12: 1–5.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1999 | 289 | 23 |
| Full Text Views | 57 | 36 | 1 |
| PDF Downloads | 62 | 34 | 1 |