Patients with severe accidental tetanus admitted to an intensive care unit in Northeastern Brazil: clinical–epidemiological profile and risk factors for mortality
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Brazilian Journal of Infectious Diseases |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702016000500457 |
Resumo: | Abstract Introduction Tetanus, an acute infectious disease, is highly prevalent worldwide, especially in developing countries. Due to respiratory failure and hemodynamic instability associated with dysautonomia, severe cases require intensive care, but little has been published regarding the management in the Intensive Care Unit. Objective To draw a 10-year clinical–epidemiological profile of Intensive Care Unit patients with severe tetanus, observe their evolution in the Intensive Care Unit and identify risk factors for mortality. Methods In this retrospective study, we used a standardized questionnaire to collect information from the records of patients with severe tetanus admitted to the intensive care unit of a referral hospital for infectious and contagious diseases in Northeastern Brazil. Results The initial sample included 144 patients, of whom 29 were excluded due to incomplete information, leaving a cohort of 115 subjects. The average age was 49.6 ± 15.3 years, most patients had no (or incomplete) vaccination against tetanus, and most were male. The main intensive care-related complications were pneumonia (84.8%) and dysautonomia (69.7%). Mortality (44.5%) was higher than expected from the mean APACHE II score (11.8), with shock/multiple organ failure as the main cause of death (72.9%). The independent factors most predictive of mortality were APACHE II score, dysautonomia, continuous neuromuscular blockade and age. Conclusion A high mortality rate was observed in our cohort of Intensive Care Unit patients with severe tetanus and a number of risk factors for mortality were identified. Our results provide important insights for the development of intervention protocols capable of reducing complications and mortality in this patient population. |
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Brazilian Journal of Infectious Diseases |
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Patients with severe accidental tetanus admitted to an intensive care unit in Northeastern Brazil: clinical–epidemiological profile and risk factors for mortalitySevere accidental tetanusIntensive care unitClinical–epidemiological tetanusTetanus in intensive care unitAbstract Introduction Tetanus, an acute infectious disease, is highly prevalent worldwide, especially in developing countries. Due to respiratory failure and hemodynamic instability associated with dysautonomia, severe cases require intensive care, but little has been published regarding the management in the Intensive Care Unit. Objective To draw a 10-year clinical–epidemiological profile of Intensive Care Unit patients with severe tetanus, observe their evolution in the Intensive Care Unit and identify risk factors for mortality. Methods In this retrospective study, we used a standardized questionnaire to collect information from the records of patients with severe tetanus admitted to the intensive care unit of a referral hospital for infectious and contagious diseases in Northeastern Brazil. Results The initial sample included 144 patients, of whom 29 were excluded due to incomplete information, leaving a cohort of 115 subjects. The average age was 49.6 ± 15.3 years, most patients had no (or incomplete) vaccination against tetanus, and most were male. The main intensive care-related complications were pneumonia (84.8%) and dysautonomia (69.7%). Mortality (44.5%) was higher than expected from the mean APACHE II score (11.8), with shock/multiple organ failure as the main cause of death (72.9%). The independent factors most predictive of mortality were APACHE II score, dysautonomia, continuous neuromuscular blockade and age. Conclusion A high mortality rate was observed in our cohort of Intensive Care Unit patients with severe tetanus and a number of risk factors for mortality were identified. Our results provide important insights for the development of intervention protocols capable of reducing complications and mortality in this patient population.Brazilian Society of Infectious Diseases2016-10-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702016000500457Brazilian Journal of Infectious Diseases v.20 n.5 2016reponame:Brazilian Journal of Infectious Diseasesinstname:Brazilian Society of Infectious Diseases (BSID)instacron:BSID10.1016/j.bjid.2016.06.007info:eu-repo/semantics/openAccessNóbrega,Marcus Vinícius Dantas daReis,Ricardo CoelhoAguiar,Isabel Cristina VerasQueiroz,Timóteo VasconcelosLima,Ana Claudia FeitosaPereira,Eanes Delgado BarrosFerreira,Raquel Feijó de Araújoeng2016-10-26T00:00:00Zoai:scielo:S1413-86702016000500457Revistahttps://www.bjid.org.br/https://old.scielo.br/oai/scielo-oai.phpbjid@bjid.org.br||lgoldani@ufrgs.br1678-43911413-8670opendoar:2016-10-26T00:00Brazilian Journal of Infectious Diseases - Brazilian Society of Infectious Diseases (BSID)false |
dc.title.none.fl_str_mv |
Patients with severe accidental tetanus admitted to an intensive care unit in Northeastern Brazil: clinical–epidemiological profile and risk factors for mortality |
title |
Patients with severe accidental tetanus admitted to an intensive care unit in Northeastern Brazil: clinical–epidemiological profile and risk factors for mortality |
spellingShingle |
Patients with severe accidental tetanus admitted to an intensive care unit in Northeastern Brazil: clinical–epidemiological profile and risk factors for mortality Nóbrega,Marcus Vinícius Dantas da Severe accidental tetanus Intensive care unit Clinical–epidemiological tetanus Tetanus in intensive care unit |
title_short |
Patients with severe accidental tetanus admitted to an intensive care unit in Northeastern Brazil: clinical–epidemiological profile and risk factors for mortality |
title_full |
Patients with severe accidental tetanus admitted to an intensive care unit in Northeastern Brazil: clinical–epidemiological profile and risk factors for mortality |
title_fullStr |
Patients with severe accidental tetanus admitted to an intensive care unit in Northeastern Brazil: clinical–epidemiological profile and risk factors for mortality |
title_full_unstemmed |
Patients with severe accidental tetanus admitted to an intensive care unit in Northeastern Brazil: clinical–epidemiological profile and risk factors for mortality |
title_sort |
Patients with severe accidental tetanus admitted to an intensive care unit in Northeastern Brazil: clinical–epidemiological profile and risk factors for mortality |
author |
Nóbrega,Marcus Vinícius Dantas da |
author_facet |
Nóbrega,Marcus Vinícius Dantas da Reis,Ricardo Coelho Aguiar,Isabel Cristina Veras Queiroz,Timóteo Vasconcelos Lima,Ana Claudia Feitosa Pereira,Eanes Delgado Barros Ferreira,Raquel Feijó de Araújo |
author_role |
author |
author2 |
Reis,Ricardo Coelho Aguiar,Isabel Cristina Veras Queiroz,Timóteo Vasconcelos Lima,Ana Claudia Feitosa Pereira,Eanes Delgado Barros Ferreira,Raquel Feijó de Araújo |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Nóbrega,Marcus Vinícius Dantas da Reis,Ricardo Coelho Aguiar,Isabel Cristina Veras Queiroz,Timóteo Vasconcelos Lima,Ana Claudia Feitosa Pereira,Eanes Delgado Barros Ferreira,Raquel Feijó de Araújo |
dc.subject.por.fl_str_mv |
Severe accidental tetanus Intensive care unit Clinical–epidemiological tetanus Tetanus in intensive care unit |
topic |
Severe accidental tetanus Intensive care unit Clinical–epidemiological tetanus Tetanus in intensive care unit |
description |
Abstract Introduction Tetanus, an acute infectious disease, is highly prevalent worldwide, especially in developing countries. Due to respiratory failure and hemodynamic instability associated with dysautonomia, severe cases require intensive care, but little has been published regarding the management in the Intensive Care Unit. Objective To draw a 10-year clinical–epidemiological profile of Intensive Care Unit patients with severe tetanus, observe their evolution in the Intensive Care Unit and identify risk factors for mortality. Methods In this retrospective study, we used a standardized questionnaire to collect information from the records of patients with severe tetanus admitted to the intensive care unit of a referral hospital for infectious and contagious diseases in Northeastern Brazil. Results The initial sample included 144 patients, of whom 29 were excluded due to incomplete information, leaving a cohort of 115 subjects. The average age was 49.6 ± 15.3 years, most patients had no (or incomplete) vaccination against tetanus, and most were male. The main intensive care-related complications were pneumonia (84.8%) and dysautonomia (69.7%). Mortality (44.5%) was higher than expected from the mean APACHE II score (11.8), with shock/multiple organ failure as the main cause of death (72.9%). The independent factors most predictive of mortality were APACHE II score, dysautonomia, continuous neuromuscular blockade and age. Conclusion A high mortality rate was observed in our cohort of Intensive Care Unit patients with severe tetanus and a number of risk factors for mortality were identified. Our results provide important insights for the development of intervention protocols capable of reducing complications and mortality in this patient population. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-10-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702016000500457 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702016000500457 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1016/j.bjid.2016.06.007 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Brazilian Society of Infectious Diseases |
publisher.none.fl_str_mv |
Brazilian Society of Infectious Diseases |
dc.source.none.fl_str_mv |
Brazilian Journal of Infectious Diseases v.20 n.5 2016 reponame:Brazilian Journal of Infectious Diseases instname:Brazilian Society of Infectious Diseases (BSID) instacron:BSID |
instname_str |
Brazilian Society of Infectious Diseases (BSID) |
instacron_str |
BSID |
institution |
BSID |
reponame_str |
Brazilian Journal of Infectious Diseases |
collection |
Brazilian Journal of Infectious Diseases |
repository.name.fl_str_mv |
Brazilian Journal of Infectious Diseases - Brazilian Society of Infectious Diseases (BSID) |
repository.mail.fl_str_mv |
bjid@bjid.org.br||lgoldani@ufrgs.br |
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1754209243780612096 |