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.
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