Gohar Ali, Wasil Khan.
An audit of mortality in Tetanus patients admitted to general intensive care unit.
J Postgrad Med Inst Jan ;19(4):429-32.

Objective: To find out the factors contributing to death from tetanus in patients admitted to general intensive care unit (ICU). Material and Methods: This descriptive study was carried out on patients admitted to General ICU, LRH from September 1, 2003 to August 31, 2004 who were shifted to General ICU and later on expired here. The data of all patients with established tetanus that expired during the stay in ICU was analyzed thoroughly. The necessary information was taken from the record of general ICU and data analysed. Results: Out of 30 patients with established tetanus, 15 (50%) expired in general ICU during one-year period. Among them, most of the patients (53.3%) were in the productive age group (11-30 years). None of them were previously immunized (actively or passively) against tetanus. Four (26.6%) of the patients had no entry wound. The entry wound of the rest of 11 (73.3%) patients had not been managed regarding tetanus. Ten out 15 (66.67%) patients were having severe disease. Autonomic instability (26.6%), septicemia (26.6%) and nosocomial pneumonia (20%) were the common complications, which have contributed to the mortality in these patients. Seven (46.7%) patients needed mechanical ventilatory support. Conclusion: The preventable disease like tetanus, which requires intensive care has a high mortality even in tertiary care hospital due to lack of immunization and proper management of wounds.

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