A Survey of Non-Traumatic Coma Etiology and Outcome in Iran

Background: The aim of this study was to assess the most common causes of Non-Traumatic Coma (NTC) and to identify outcome predictive factors. Method: This study was performed on non-traumatic comatose children aged 2 months to 14 years old were referred to emergency wards of Birjand’s Valiasr and Imam Raza hospitals from 2017 to 2018. Questionnaires including her/his clinical status, demographic data, and Para-clinic results, were completed by parents of the patients. The cause of Coma was determined based on the diagnosis of the patient’s clinician. Findings: The most common cause of coma in children were toxic causes (38 persons, 37.25%), other causes were respectively consist of infectious, congenital, neurologic, metabolic, hematologic, foreign body aspiration and malignancies. There was a significant correlation between mortality and the history of previous diseases, primary GCS, vital signs in the time of referral, pupil's size, pupil's reflex, deep tendon reflex, foot skin reflex, MCH, MCV, platelet, Calcium, PH, BUN, CRP, sonographic results and final diagnosis of the patients. Conclusions: This study showed that the history of previous diseases, primary GCS, vital signs in the time of referral, and clinical properties such as pupil size, pupil reflex, and foot skin reflex were the most important factors had predictive value for outcome in non-traumatic unconscious pediatric patients.