In-Hospital Mortality among Patients of Severe Adult Tetanus Presenting with bad Prognostic Factors: A Tertiary Care Hospital Experience

Background: Tetanus caused by clostridium tetani, despite being a preventable disease, is still posing significant health hazard to developing countries like Pakistan. Objective: To determine in-hospital mortality among patients of severe adult tetanus presenting with bad prognostic factors.Material and Methods: This cross-sectional study was conducted at the Department Medicine, Medical Teaching Institution Lady Reading Hospital, Peshawar, Pakistan from July 13, 2017, January 2018, on 176 patients. All as per Ablett Classification factors (incubation period <7 days, persistent fever >40o C, tachycardia >120/min, no history post-exposure prophylaxis) were included in study. Patients compromised renal functions (urea >108 mg/dl, reduced urine output <50 ml/hr) already diagnosed neuromuscular junction disorders excluded Written informed consent obtained enrolled immediately worked up detailed clinical examinations managed ICU protocols followed within hospital for mortality.Results: Mean age participants 47±10.27 years. The majority subjects males (n=102, 58%), un-immunized (n=88, 50%) or partially immunized (n=26, 15%), socioeconomically poor (n=84, 48%), illiterate (n=82, 47%) urban areas (n=114, 65%). In-hospital recorded 109 (62%) subjects. In highest an range 41-65 years (n=70/109, 64.22%), (n=63/109, 57.8%), unimmunized (n=55/109, 50.45%), (n=52/109, 47.7%), (n=51/109, 46.78%) (n=71/109, 65.14%). Conclusion: high factors.Keywords: Clostridium Hospital Mortality, Severe tetanus, Tetanus, Antitoxin, Toxoid, Trismus, Prognostic Factors.