title: [Mortality trend due to accidental tetanus from 1981 to 2004 in Pernambuco and analysis of the impact on intensive care unit attendance].
abstract: Despite reductions in the incidence of accidental tetanus cases in Brazil, there has not been any significant decrease in its mortality. In this case series, the mortality rates before and after establishing standard management practices for tetanus patients in the intensive care unit at the Oswaldo Cruz University Hospital are compared over the period from 1981 to 2004. Over these 24 years, 1.971 patients were admitted. Before establishing the intensive care unit management, the mortality rate was 35%. The Intensive care unit for attending to tetanus patients was established in 1997. From 1998 to 2004, the mortality rate fell to 12.6%: OR = 0.27 (95% CI = 0.18-0.39); p < 0.001. This trend was seen in all age groups and both sexes. The centralization of attendance for these patients into a single specialized service with early treatment in an intensive care unit has therefore been decisive in reducing the mortality rate. This service can count on the medical team's vast experience of tetanus management, with better treatment of symptoms that forestalls the serious complications from this disease.
authors.affiliation: Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, PE. pedroalves@click21.com.br
authors.forename: Pedro Alves da Cruz
authors.initials: PA
authors.lastname: Gouveia
authors.forename: Cláudia Elise Ferraz
authors.initials: CE
authors.lastname: Silva
authors.forename: Demócrito de Barros
authors.initials: Dde B
authors.lastname: Miranda Filho
authors.forename: Sylvia Nery
authors.initials: SN
authors.lastname: Bernardino
authors.forename: Abelardo Gonçalves
authors.initials: AG
authors.lastname: Escarião
authors.forename: Ricardo Arraes de Alencar
authors.initials: RA
authors.lastname: Ximenes
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001938:Brazil / Q000453:epidemiology; D002648:Child; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017678:Sex Distribution; D013742:Tetanus / Q000401:mortality* / Q000628:therapy; D055815:Young Adult