Tetanus- disease patterns observed in a specialist unit | [Journal of College of Physicians and Surgeons--Pakistan : JCPSP • 2000]

Author(s):

1. Muhammad Abbas Raza: North Medical Ward, Mayo Hospital, Lahore, Pakistan

2. Muhammad Hasan Abbas: South Surgical Ward, Mayo Hospital, Lahore, Pakistan

Abstract:

An observational retrospective study was conducted in a specialized tetanus ward in a tertiary care hospital over one year period to see if tetanus has changed its face in our set up in modern times and to redefine prognostic factors.The result showed that tetanus remained a disease of younger age group (mean age 35.02 ± 16.02). Overall mortality was 29.9% affecting, men in majority (69.2%). Most of the patients were poor (90.7%), belonged to rural background (65.4%) and were manual workers. Illegal abortion remained an important etiology (33% of female patients). Bad prognostic factors included older age > 60 years (76.9% mortality Odds Ratio [OR] 7.81, 95% Confidence Interval [Cl] 2.30 to 26.51), major fits (84.5% mortality, OR 5.27,95% Cl 2.74 to10.12), short time from lock jaw to first fit (especially less than 2 days), an initial pulse rate > 110/m (50% mortality, OR 2.34, 95% Cl 1.75 to 3.13), pulse rate variation of more than 40/minute in a short period (63.2% mortality, OR 4.02, 95% Cl 1.74 to 9.26), profuse sweating (61.2% mortality, OR 3.70,95% Cl 2.84 to 5.51), aspiration pneumonia (85.7% mortality, OR 14.06, 95 Cl 4.45 to 44.41) and a higher temperature at presentation without accountable infections. Seventy-five percent mortality occurred in first 4 days. Final outcome was not primarily influenced by incubation period, nature of injury, sex or occupation.Tetanus has probably not changed its outlook in developing countries. It is possible to triage patients into low and high-risk group on reception.

Page(s): 249-254

DOI: DOI not available

Published: Journal: Journal of College of Physicians and Surgeons--Pakistan : JCPSP, Volume: 10, Issue: 7, Year: 2000

Keywords:

Tetanus , Mortality Prognosis

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