Prognostic factors in Adult Tetanus in a Tertiary referral Centre.

Abstract

Background: Tetanus is a cause of painful and avoidable deaths in Nigeria. The aim of this study is to identify the factors that significantly contribute to the outcome of adult tetanus at Obafemi Awolowo University Teaching Hospitals' Complex.
Method: Medical records of adult patients (≥ 16years) admitted for tetanus at the Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife was retrospectively reviewed over a 10year period (1998-2007).
Results: Tetanus mostly results from minor wounds. Males were more affected (4:1) and the median age of affected adult was 28years (interquartile range 20-40years). The mortality rate was 46.9%. Multivariate logistic regression analysis revealed that the onset period (odds ratio 0.94, 95% CI 0.91-0.98), the duration between symptom and admission (odds ratio 0.6, 95% CI 0.38- 0.94), and temperature of the patient (odds ratio 2.66, 95% CI 1.02- 6.97) were important prognostic factors in this study. Conclusion: Mortality rate from adult tetanus is still very high in our environment. The presence of factors indicating an adverse outcome in patients on admission will help identify the patients that will require more intensive management. Immunization prophylaxis is recommended for all individuals and patients.

Key Words: tetanus, adult, prognostic factors.