Factors affecting the prognosis of Albanian adult patients with generalized tetanus.
BACKGROUND
Despite systematic vaccination of the population, tetanus continues to be a health problem in Albania, as in some other developing countries. In this study, our intent was to evaluate prognostic factors relating to death in adult patients with generalized tetanus.


METHODS
All the patients (60) included in the study were hospitalized at the regional hospitals of Shkodra and Korça, and the University Hospital Centre "Mother Theresa" of Tirana, Albania, during the period of 1984-2004. They had a mean age of 49.1+14.4 years, 43 (71.7%) were males and 40 (66.6%) of them lived in rural areas. The mean incubation period was 12 days and the case-fatality rate (CFR) was 38.3%.


RESULTS
The CFR in patients with an onset period ≥2 days was 21.7% and in those with <2 days was 48.6%, OR=0.29 (p<0.05). Patients >50 years old had a CFR=60.87% (OR=7, p<0.05). We found the high CFR to be significantly associated with urban residency, male gender, complicated wound, head localization, fever ≥ 38.4 °C, tachycardia > 120 beats/min, and hypertension.


CONCLUSIONS
The main prognostic factor of those analyzed in our study appeared to be the onset period and the age of the patients. We didn't find significant differences in CFR in patients with different incubation periods. Clinicians must take into account that wound complication and localization, tachycardia and hypertension, high fever, male gender and urban residency significantly influence the prognoses of adults with generalized tetanus.
Service of Infectious Diseases, University Hospital Center "Mother Theresa", Tirana, Albania.
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Pilaca
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Beqiri
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Ndreu
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Puca
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Pepa
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Elezi
D000293:Adolescent; D000328:Adult; D000415:Albania / Q000453:epidemiology; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013742:Tetanus / Q000401:mortality*; D055815:Young Adult