14. The Clinical Characteristic and Treatment outcome of Tetanus Patients in Tertiary Care Hospital
Wasil Khan and Abdul Jabbar
Objective: To describe the clinical characteristic and treatment outcome of tetanus patients admitted to Medical Unit of STH Swat.
Study Design: Cross sectional study.
Place and Duration of Study: This study was conducted at the Medicine Department of Saidu Group of Teaching Hospital Swat from 16-02-2013 to 14-07-17.
Materials and Methods: This case series study was carried out on patients with established tetanus admitted to Medical Unit of SGTH Swat, from 16/02/13 to 14/07/17 and later on discharged, expired or referred to other teaching hospitals of the province. A total of 42 consecutive patients were included in the study. The relevant information including complications like cellulitis, autonomic instability, nosocomial pneumonia, acute renal failure, hyperthermia, respiratory failure and cause of death were recorded on a Performa which was maintained for every patient from admission to outcome. Analysis was done in SPSS version 20.
Results: The mean age of the patients presenting with tetanus was 30.5714 with minimum age of 10 years and maximum of 75 years. The male to female gender ratio was 7:1 with 88.1 % male and 11.9% female. None of these patients were previously immunized against tetanus. 28.60% patients were having no apparent route of possible entry while 26.20% had entry wound on lower limb, 19.03% on upper limb, 19.3% had post-surgical/obstrictcal wound and 7.14% having wound on face or neck. Most of the patients (40.47%) stayed in the unit from 1 to 7 days while 33% for less than 24 hours and 26.20% for more than 7 days. The complications developed were cellulitis in 26.20%, autonomic instability 26.20%, nosocomial pneumonia 16.70%, acute renal failure 11.90% hyperthermia 9.50% and respiratory failure 9.50%. Ten (23.8%) patients needed tracheostomy. 3 (7.14%) patients needed mechanical ventilator support who were referred to other hospitals of the province. Out of 42 patients with established tetanus, 13 (31%) expired. All of these expired patients were having severe disease on the basis of Philips Scoring System. The immediate cause of death was respiratory arrest 30.79%, cardiac arrest 23.07%, renal failure 23.07% and septic shock 23.07%.
Conclusion: The preventable disease like tetanus has a high mortality even in tertiary care hospital due to lack of immunization and proper management of wounds.
Key Words: Tetanus Clinical characteristic, Treatment outcome.
Citation of articles: Khan W, Jabbar A. The Clinical Characteristic and Treatment outcome of Tetanus Patients in Tertiary care Hospital. Med Forum 2017;28(12):56-59.