COMPLICATIONS IN PATIENTS ADMITTED WITH TETANUS IN GENERAL ICU AND MEDICAL DEPARTMENT OF LADY READING HOSPITAL PESHAWAR

ABSTRACT
Background: Tetanus remains a major health problem in the developing world. The aim of this study was to evaluate
the complications in patients admitted with tetanus.
Methodology: A six months cross-sectional study of Ninety one cases of tetanus was conducted in the Intensive
Care Unit (ICU) and Medical Departments of Lady Reading Hospital, Peshawar, Pakistan, between August 2012 and
February 2013. Most of the patients were males 61 (67.03%) and male to female ratio was 2:1. There were 64 cases
of tetanus patients having age above 30 years. Relevant data was collected from the patient’s record by means of a
structured questionnaire.
Results: Results of 91 patients were analyzed, n=51 (56.04%) had localized, n=2 (2.21%) had cephalic while n=38
(41%) had generalized type of tetanus. The severity of tetanus was categorized as: severe in n=22 (24.18%), moderate
in n=26 (28.57%) and mild in approximately n= 22 (24.18%).Approximately n=37 (40.66%) had positive history of
wound/injury while n=54 (59.34%) had no history of any minor or major wound/injury in near past. Out of all 91 tetanus
patients, the following complications were noticed; sepsis in n=14 (15.38%), aspiration pneumonia in n=28 (30.77%),
laryngospasm in n=19 (20.88%), break in bone in n=2 (2.2%), disability in n=25 (27.47%), acute renal failure in n=24
(26.37%), respiratory failure in n=33 (36.26%), hospital acquired infections in n=32 (35.16%), dysautonomias in n=53
(58.24%), and sudden cardiac arrest in n=25 (27.47%).
Conclusion: Our study concludes that most of the tetanus patients were older than 30 years had high rate of complications
due to the diseases itself or may be contributed to the management of tetanus cases. Prophylactic use of
antibiotics and treating tetanus patients in a well highly equipped Intensive Care Unit is recommended to avoid complications
and high mortality rate.
Key Words: Tetanus, Complications, Mortality, Intensive Care Unit, Lady Reading, Hospital, Peshawar