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Prognostic Factors of Brauner et al for a Patient with Severe Tetanus

Description

Brauner et al identified prognostic factors for mortality in a patient hospitalized with severe tetanus. This can help identify a patient who may require more aggressive management. The authors are from Rio Grande do Sul in Brazil and the University of Virginia.


 

Parameters identified with poor prognosis in multivariate analysis:

(1) short onset period (time from first symptom to first spasm)

(2) cardiac arrest

(3) infection (pneumonia, urinary tract, other)

(4) acute renal failure

(5) hypotension

(6) long symptomatic period (time from first to last muscle spasm)

 

where:

• A cardiac arrest had an odds ratio for mortality of 27.

• The odds ratios for infection, ARF and hypotension ranged from 3.5 to 5.

• Some patients had symptomatic periods of over 2 months (Table 1, page .932)

 

Factors associated with a better prognosis:

(1) optimum intensive care

(2) control of autonomic dysfunction

 


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