Non-traumatic coma in childhood: clinical variables in prediction of outcome.

One hundred and four children suffering from non-traumatic coma were referred to the Pediatric Neurology Service, Children's Hospital, Winnipeg, between February 1976 and December 1978. Stepwise discriminant analysis was used to obtain a classification function of outcome, based on clinical variables determined at two separate time-periods of examination: (1) the time of admission and (2) about 24 hours after onset of coma. 12 clinical variables were included in the stepwise procedure. Seven of these: coma severity, extra-ocular movements, pupils, motor patterns, blood pressure, temperature and seizure type, entered the classification function for the first time-period, data being available for 102 children. 75 per cent of these cases were correctly classified into one of five outcome groups and 8 per cent were seriously misclassified. Similarly, 67 per cent of the 66 children evaluated in the second time-period were correctly classified and 3 per cent seriously misclassified. The variables that entered the classification function in this second time-period were age, coma severity, motor patterns, blood pressure and seizure type. The data suggest that the analysis of clinical variables recorded early in the comatose state can provide predictive information, and stepwise discriminant analysis may be one method of determining the most likely outcome for individual cases.