Accidental tetanus: prognosis evaluation in a historical series at a hospital in Salvador, Bahia, Brazil

Abstract

A total of 868 (84.89%) patients diagnosed with tetanus were studied, out of the 1,024 tetanus patients hospitalized at Couto Maia Hospital (Salvador, Bahia, Brazil), during the period between 1986 and 1997. Of this group (n = 868), 63.5% (n = 551) were discharged, 35.4% (n = 307) died, and 1.1% (n = 10) were transferred. The average age of the deceased patients (38.73 +/- 23.31 years) was significantly greater (p < 0.0001) than the age of those who survived (29.21 +/- 20.05 years). Analyzing the variables of the logistic regression model with statistic significance (p < or = 0.25) for univariate analysis, we observed a greater association of risk for worst prognosis (death) in patients aged > or = 51 years; time of illness < 48 hours; time of incubation < 168 hours; neck rigidity; spasms; opisthotonos; body temperature > or = 37.7 degrees C; heart beat > or = 111 beats/minute; sympathetic hyperactivity and association with pneumonia. Among the group of those who survived, patients with 1 to 5 of those variables (n = 398; 76.8%) were more frequent, while among patients of the group of the deceased, 70.3% (n = 206) presented 6 to 10 of those variables, with a highly significant difference (p < 10(-8)). In conclusion, the indicators described provide early information that may guide the prognosis and medical and nurse care.

Tetanus in adults: Clinical presentation, treatment and predictors of mortality in a tertiary hospital in Ethiopia

“…The case-fatality in our study was 35.3% which is consistent with other studies [4,8,11,14,19,22] and the findings of which vary from 32% to 39%. In contrast to our finding, both lower (15% to 27%) [3,12,15,16,18,23,24] and higher (55% to 72.7%) [9,10,13,17,21] casefatalities were observed.…”

“…Lack of clean delivery is an important risk factor for neonatal tetanus. Tetanus is a severe disease associated with a high mortality which varies from 15% to 72.2% [3,4,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] depending on the available treatment facilities. Treating tetanus patients in intensive care unit (ICU) improves the survival rate [23].…”

Tétano Grave Associado a Choque Séptico Em Uma Paciente Idosa Internada Em Unidade De Terapia Intensiva

“…Apesar da redução na incidência de casos de tétano acidental no Brasil, não tem havido um decréscimo significativo da sua mortalidade. A centralização do atendimento prestado a esses pacientes em um único serviço especializado com o tratamento precoce em UTI tem sido decisiva para a redução da taxa de mortalidade (26). Este serviço conta com uma equipe médica e de enfermagem com vasta experiência, o que pode proporcionar melhor tratamento dos sintomas e prevenir complicações graves desta doença (22).…”

Impacto epidemiológico y económico de la vacunación contra el tétanos en adultos de Colombia

“…Comparando con Brasil, donde los resultados de estudios sobre letalidad causada por tétanos difieren de los reportados en Colombia (p. ej. tasas más elevadas en las mujeres), también hay coincidencia en que las tasas son más altas en personas mayores de 50 años de edad (24,34,35). Asimismo, estudios realizados en Nigeria también se alinean con la letalidad observada entre 2000 y 2007 en algunos departamentos de la costa atlántica colombiana (30% al 50%) (36,37).…”