Prognostic factors affecting deaths from adult tetanus.
The objective of this study was to determine prognostic factors related to death from adult tetanus. Fifty-three cases of tetanus, 25 females and 28 males, were treated in Cukurova University Hospital during 1994-2000. The mean age was 46.6 years. Forty-one (77.7%) patients came from rural areas. Most (64.1%) cases had minor trauma, but 19 (35.8%) had deep injuries. The mean incubation period was 11.5 days. Mortality was high (52.8%), caused by cardiac or respiratory failure or complications, and was related to the length of the incubation period. In cases with an incubation period < or = 7 days, the mortality rate was 75% (p 0.07). Mortality was significantly associated with generalised tetanus (p < 0.05), fever of > or = 40 degrees C, tachycardia of > 120 beats/min (p < 0.05), post-operative tetanus (p 0.03), and the absence of post-traumatic tetanus vaccination (p 0.068). Patients who were given tetanus human immunoglobulin or tetanus antiserum (p > 0.05) had similar outcomes. Patients who were given penicillin had a mortality rate similar to patients who were given metronidazole (p 0.15). The mortality rate was higher (92%) in patients with severe tetanus than in patients with moderate disease (53%). By multivariate analysis, the time to mortality caused by tetanus, and also the mortality rate, were both related significantly to age and tachycardia.
Saltoglu
N
N
Department of Infectious Diseases and Clinical Microbiology, University of Cukurova, Faculty of Medicine, Adana, Turkey. nsalt@mail.cu.edu.tr
Tasova
Y
Y
Midikli
D
D
Burgut
R
R
Dündar
I H
IH
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007114:Immunization; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013742:Tetanus / Q000401:mortality*; D013997:Time Factors