Tetanus: a recurring intensive care problem.
A fifteen-year retrospective study of 108 cases of tetanus admitted to the Intensive Care Unit (ICU) at the University Hospital of the West Indies is presented. Males predominated (70%), with peak incidence occurring amongst the young and the elderly. In 57% the disease was severe enough to require neuromuscular blockade and controlled ventilation. Respiratory complications occurred most commonly (80%), predominantly as a result of infection. Dysautonomia, exhibited by 55% of patients, presented the greatest difficulty in management. Mortality was high (20%), with sudden cardiac arrest being the most common cause of death. The average duration of stay in the ICU was long (27 days). As Jamaica is a Third World country with limited resources, the continued occurrence of this preventable disease represents a drain on existing intensive care funds. This must be brought to the attention of institutions responsible for planning health care programmes for developing countries.
Harding-Goldson
H E
HE
Department of Anaesthetics and Intensive Care, University Hospital of the West Indies, Mona, Kingston, Jamaica.
Hanna
W J
WJ
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D002648:Child; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D007563:Jamaica / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012737:Sex Factors; D013742:Tetanus / Q000150:complications* / Q000453:epidemiology* / Q000401:mortality