A new prognostic scoring system in neonatal tetanus.
A prospective study of 75 cases of neonatal tetanus was carried out with a view to developing a prognostic scoring system which can be used to assess the severity of the disease and to serve as a basis for comparing results of different therapeutic interventions from various centres. The case fatality rate was 77.3%. A table was designed containing 6 parameters and a rating of 1 to 4 was given to each parameter in decreasing order of severity. The minimum total score attainable was 6 and the maximum 24 (the severity of the disease was inversely proportional to the score). The differences between the means of each of the parameters among patients who died and the survivors were significant (P < 0.005). Regression analysis showed that each of the parameters independently had a significant effect on the total score (P < 0.005). Using the percentage mortality at each score, a pattern emerged such that total scores of 6-11 indicated severe tetanus (mortality rate 100%); 12-17, moderate disease (mortality rate 68%), and total scores of > 17 indicated mild neonatal tetanus (mortality rate 18%). Associated poor prognostic factors identified included pneumonia, recurrent apnoea, cyanosis, and opisthotonus.
Osinusi
K
K
Department of Paediatrics, University College Hospital, Ibadan, Nigeria.
Njinyam
M N
MN
D017668:Age of Onset; D001049:Apnea / Q000382:microbiology; D003490:Cyanosis / Q000382:microbiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009549:Nigeria; D011014:Pneumonia / Q000382:microbiology; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D015203:Reproducibility of Results; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis; D013742:Tetanus / Q000145:classification / Q000150:complications / Q000151:congenital* / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy