Severity of Tetanus in Patients Older than 80 Years: Comparative Study with Younger Patients

Nolla-Salas, M; Garcés-Brusés, J

doi:10.1093/clind/16.4.591

Cited by 12 publications

(6 citation statements)

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“…The case-control study also allowed each risk factor to be adjusted for the effect of the others either in the same group or in the other sets of variables, achieving a better understanding of the interrelationships among each variable, the outcome and additional factors, minimizing the problem of confounding factors among the variables studied. Third, finally, because this study has not only ratified the importance of certain factors already recognized in the literature as being important in determining the tetanus patient's prognosis (age 11 , short incubation and progression periods of onset 1,3,4,5,6,16,17 , presence of spasms in the first 24 hours 1 ), but also pointed out other prognostic indicators as yet little used (time elapsed between onset of symptoms and admission to hospital 1 ) or even unmentioned in the literature consulted (occurrence of neck stiffness in the first 24 hours and the occurrence of respiratory signs and symptoms in the first 24 hours of hospitalization, such as the presence of at least one of the following: tachypnea, dyspnea, attacks of apnea, rhonchi or respiratory crepitations, cyanosis, cough, bronchial spasms, pleuritic pain).…”

Section: Discussionmentioning

confidence: 68%

Identification of risk factors for death from tetanus in Pernambuco, Brazil: a case-control study

Miranda-Filho

Ximenes

Bernardino

et al. 2000

Rev. Inst. Med. trop. S. Paulo

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A case-control study was conducted to identify risk factors for death from tetanus in the State of Pernambuco, Brazil. Information was obtained from medical records of 152 cases and 152 controls, admitted to the tetanus unit in the State University Hospital, in Recife, from 1990 to 1995. Variables were grouped in three different sets. Crude and adjusted odds ratios, p-values and 95% confidence intervals were estimated. Variables selected in the multivariate analysis in each set were controlled for the effect of those selected in the others. All factors related to the disease progression - incubation period, time elapsed between the occurrence of the first tetanus symptom and admission, and period of onset - showed a statistically significant association with death from tetanus. Similarly, signs and/or symptoms occurring on admission or in the following 24 hours (second set): reflex spasms, neck stiffness, respiratory signs/symptoms and respiratory failure requiring artificial ventilation (third set) were associated with death from tetanus even when adjusted for the effect of the others.

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Section: Discussionmentioning

confidence: 68%

Identification of risk factors for death from tetanus in Pernambuco, Brazil: a case-control study

Miranda-Filho

Ximenes

Bernardino

et al. 2000

Rev. Inst. Med. trop. S. Paulo

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“…6 Orta dere-celi olgularda mortalite %5-10 oranında seyrederken ağır dereceli olgularda bu oran %50' den yüksek saptanmıştır. 7 Olgumuzda en sık görülen klinik olan jeneralize tetanos tablosu vardı. Trismus, yaygın kasılmalar, yutma güçlüğü mevcuttu, ancak ateş ve taşikardi yoktu.…”

Section: Discussionunclassified

Aşısız Mülteci Bir Vakada Tetanos

Çamdağ

Özdemir

Elmas

et al. 2020

Sakarya Medical Journal

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Tetanos, Clostridium tetani'nin ürettiği ekzotoksinlerin neden olduğu, nadir ve ölümcül seyredebilen bir hastalıktır. Çocukluk çağının hiçbir aşısı yapılmamış olan ve mülteci olarak ükemize gelen yedi yaş erkek hasta tüm vücutta kasılma ve ağrı şikâyeti ile başvurdu. Alınan öyküsünden bir hafta önce düşme sonrası ayağına paslı çivi battığı ve sonrasında herhangi bir sağlık kuruluşuna başvurmadığı öğrenildi. Hastaya tetanos tanısı konuldu ve çocuk yoğun bakım ünitesinde izleme alındı. Hastaya tetanos aşısı ve tetanos immünglobulin yapıldı. Penisilin tedavisi başlandı. Yara yeri debride edildi. Takibinde kasılmaları artan ve solunum sıkıntısı gelişen hasta entübe edildi. Sonrasında arrest olan hastaya kardiyopulmoner resusitasyon uygulandı. Hastanın izleminde akut böbrek yetmezliği ve dissemine intravasküler koagülasyonun eşlik ettiği çoklu organ yetmezliği gelişti ve takibinde exitus oldu. Sonuç olarak, ülkemizde görülme sıklığındaki artış nedeni ile özellikle yaralanmalar sonrası santral sinir sistemi bulguları ile başvuran hastalarda aşı öyküsü mutlaka sorgulanmalı ve ayırıcı tanıda tetanos mutlaka düşünülmelidir.

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“…It is known that interventions currently adopted in the treatment of severe diseases such as tetanus tend to be more effective due to technological advances and improved care in intensive care units, resulting in an important reduction of lethality in places where such resources are available (11,14,(20)(21)(22). Death from tetanus can vary from 6 to 60% depending on the places where treatment is provided, the severity of the disease and the therapeutic measures adopted (8,10,20,22,23).…”

Section: Discussionmentioning

confidence: 99%

“…Death from tetanus can vary from 6 to 60% depending on the places where treatment is provided, the severity of the disease and the therapeutic measures adopted (8,10,20,22,23). In hospitals where death from tetanus is low due to the reasons cited above, comparing this indicator (death from tetanus) alone among the groups of patients subjected to different treatments requires very large samples.…”

Section: Discussionmentioning

confidence: 99%

Clinical classification of tetanus patients

Miranda-Filho¹,

Ximenes²,

Barone³

et al. 2006

Braz J Med Biol Res

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The authors propose a clinical classification to monitor the evolution of tetanus patients, ranging from grade I to IV according to severity. It was applied on admission and repeated on alternate days up to the 10th day to patients aged ≥12 years admitted to the State University Hospital, Recife, Brazil. Patients were also classified upon admission according to three prognostic indicators to determine if the proposed classification is in agreement with the traditionally used indicators. Upon admission, the distribution of the 64 patients among the different levels of the proposed classification was similar for the groups of better and worse prognosis according to the three indicators (P > 0.05), most of the patients belonging to grades I and II of the proposed classification. In the later reclassifications, severe forms of tetanus (grades III and IV) were more frequent in the categories of worse prognosis and these differences were statistically significant. There was a reduction in the proportion of mild forms (grades I and II) of tetanus with time for the categories of worse prognostic indicators (chi-square for trend: P = 0.00006, 0.03, and 0.00000) whereas no such trend was observed for the categories of better prognosis (grades I and II). This serially used classification reflected the prognosis of the traditional indicators and permitted the comparison of the dynamics of the disease in different groups. Thus,

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Severity of Tetanus in Patients Older than 80 Years: Comparative Study with Younger Patients

Cited by 12 publications

References 0 publications

Identification of risk factors for death from tetanus in Pernambuco, Brazil: a case-control study

Identification of risk factors for death from tetanus in Pernambuco, Brazil: a case-control study

Aşısız Mülteci Bir Vakada Tetanos

Clinical classification of tetanus patients

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