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PAEDIATRIC ALTERED
CONSCIOUS LEVEL GUIDELINE |
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EVIDENCE-BASED SEARCH
The causes of altered consciousness in children
Background
Children who have an altered conscious level do so for a
variety of reasons. To determine how they should be treated a knowledge of the
diagnoses which result in altered consciousness is required.
Objectives
To determine the diagnoses which present with altered
consciousness in children and the incidence in which they occur.
Paper selection criteria
Inclusion criteria were drawn up before the search took place.
Papers were selected if they were prospective epidemiological studies,
performed in developed countries, which were either population or hospital
based, and looked specifically at children presenting with altered conscious
level or coma. Papers which studied adults and children would only be included
if the data for children could be analysed separately. Papers published in a
foreign language would be searched for and referenced but not included in the
final selection of papers due to limited translation facilities.
Search strategy
A review of the Cochrane library, MEDLINE (1966-present),
EMBASE (1980-present), CINAHL (1982-present), British Nusing Index
(1985-present) and AMED (1985-present) was performed on
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# |
Search History |
Results |
|
1 |
exp COMA/ or exp |
28738 |
|
2 |
exp confusion/ or exp coma/ or exp coma, post-head injury/ |
35256 |
|
3 |
exp |
5840 |
|
4 |
1 or 2 or 3 |
40532 |
|
5 |
exp adolescent/ or exp child/ or exp child, preschool/ or exp infant/ or exp infant, newborn/ or exp adolescent, hospitalized/ or exp child, hospitalized/ |
2726715 |
|
6 |
4 and 5 |
8629 |
|
7 |
exp diagnosis/ or exp diagnosis, differential/ |
4884436 |
|
8 |
cause.mp. |
558507 |
|
9 |
(aetiology or etiology).mp. [mp=ab, hw, ti, sh, it, tn, ot, dm, mf, rw] |
334586 |
|
10 |
7 or 8 or 9 |
5490242 |
|
11 |
exp epidemiologic studies/ or exp case-control studies/ or exp retrospective studies/ or exp cohort studies/ or exp longitudinal studies/ or exp follow-up studies/ or exp prospective studies/ or exp control groups/ |
1427086 |
|
12 |
10 and 11 |
602098 |
|
13 |
6 and 12 |
1354 |
Search results
From 1354 titles, a total of
21 abstracts were reviewed.
From a hand search of the
references a further 4 abstracts were reviewed.
4 papers were selected for review from the abstracts selected. [1-4]
Only Wong et al was included,
as the other papers were from developing countries (the aetiology of coma is
potentially significantly different [2, 3]) and Lohr et al was published in
Portuguese.
1. Wong, C., et al., Incidence, aetiology, and outcome of non-traumatic coma: a population based study. Archives of Diseases of Childhood, 2001. 84(3): p. 193-9.
2. Sofiah, A. and I. Hussain, Childhood non-traumatic coma in Kuala Lumpar, Malaysia. Annals of Tropical Paediatrics, 1997. 17(4): p. 327-31.
3. Ogunmekan, A., Non-traumatic coma in childhood: Etiology, clinical findings, morbidity, prognosis and mortality. Journal of Tropical Pediatrics, 1983. 29(4): p. 230-2.
4. Lohr Junior, A., et al., Acute coma in children: etiology, morbidity and mortality. Arquivos de Neuro-Psiquiatria, 2003. 61(3A): p. 621-4.