Evaluating Non-Traumatic Loss of Consciousness in Children Admitted to the Emergency Room

Authors

1 Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

2 School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Background: Non-traumatic loss of consciousness is a nonspecific symptom result from a broad range of diseases in children, and its outcome depends on factors, including its primary etiologies, age, sex, and patient clinical condition at the time of admission. The purpose of this study was to evaluate the etiology and outcome of children's non-traumatic loss of consciousness and determining predictive clinical and paraclinical features.
Methods: This retrospective cross-sectional study was conducted in Imam Hossein Hospital, Isfahan, Iran. Documents of 101 children aged one month to fifteen years old admitted with non-traumatic loss of consciousness in March 2016 to March 2017 were reviewed. Data regarding patient’s profile, signs and symptoms, paraclinical findings, progression, and outcome were collected and analyzed using SPSS software version 23.0 and Chi-square test.
Results: We indicated that the most common cause was infections (40.6%), followed by seizure (23.8%) and intoxication (19.8%). Also, infection was the main cause of mortality. The mortality rate was 18.8% and significantly and directly correlated with duration of hospitalization, intensive care unit (ICU) admission, and emergency interventions such as intubation or cardiopulmonary resuscitation (CPR) at the time of admission, status seizure, dehydration, irritability, poor feeding, oliguria, hypotension, non-reactive pupils, low oxygen saturation, hyporeflexia, and hypotonia. Moreover, paraclinical factors such as thrombocytopenia, neutropenia, impaired liver and kidney function tests, and high coagulation test predicated poor outcomes.
Conclusion: The most common cause of non-traumatic loss of consciousness and the most common cause of mortality was infection. Longer duration of hospitalization, ICU admission and interventions were associated with poor outcomes. We suggest physicians should pay more attention to these predictive factors. 
 

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