埃塞俄比亚西南部吉马大学教学医院成人破伤风的病死率
Case-fatality of adult tetanus at Jimma University Teaching Hospital, Southwest Ethiopia.
作者信息
Amare A, Yami A
机构信息
Addis Ababa University, Medical Faculty, Department of Neurology, Addis Ababa, Ethiopia.
出版信息
Afr Health Sci. 2011 Mar;11(1):36-40.
BACKGROUND
Tetanus remains a major health problem in Ethiopia like in most other developing countries.
OBJECTIVES
To assess the clinical presentation, complications and outcome of tetanus patients.
METHODS
In this retrospective study, patients (age > 13 years) who were admitted to Jimma University Teaching Hospital from 1996 to 2009 were included.
RESULTS
Data from 171 patients were analyzed (129 males, 42 females, mean age 33 years). The mean hospital stay for patients discharged cured and deceased was 21.5 ± 12 and 6.5 ± 6.7 days, respectively. None of our patients was immunized for tetanus. Tracheostomy and mechanical ventilation (MV) was done in 10.5% and 11 %, respectively. The case-fatality was 38%. The mean annual admission and case-fatality increased over the study period from 9 to 20.5 and from 21 % to 51%, respectively. Establishment of intensive care unit (ICU) did not improve mortality due to infrequent tracheostomy and MV.
CONCLUSIONS
The case-fatality was high like in most other studies and the majority of patients died in the first few days indicating that adequate respiratory support was not given. Establishment of ICU did not improve mortality. Tetanus can be prevented by vaccination and if it occurs it needs well equipped ICU.
背景
与大多数其他发展中国家一样，破伤风在埃塞俄比亚仍然是一个主要的健康问题。
目的
评估破伤风患者的临床表现、并发症及预后。
方法
在这项回顾性研究中，纳入了1996年至2009年期间入住吉马大学教学医院的患者（年龄>13岁）。
结果
分析了171例患者的数据（129例男性，42例女性，平均年龄33岁）。治愈出院患者和死亡患者的平均住院时间分别为21.5±12天和6.5±6.7天。我们的患者均未接种破伤风疫苗。分别有10.5%和11%的患者进行了气管切开术和机械通气。病死率为38%。在研究期间，年平均入院人数和病死率分别从9例增加到20.5例，从21%增加到51%。由于气管切开术和机械通气不常见，重症监护病房（ICU）的设立并未降低死亡率。
结论
与大多数其他研究一样，病死率很高，大多数患者在最初几天内死亡，这表明没有给予足够的呼吸支持。ICU的设立并未降低死亡率。破伤风可通过接种疫苗预防，一旦发生则需要设备完善的ICU。
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