Tetanus in an intensive care unit of a Turkish hospital: Patient analysis of a 6-year period

Aim: To retrospectively evaluate the clinical features of patients admitted to the medical intensive care unit (ICU) of ourhospital between January 2001 and May 2007 due to tetanus. Materials and methods: Patient vaccination history, incubation period, nosocomial infections, noninfectious conditions,mortality, and length of stay in the ICU and hospital were documented. Results: Fifteen tetanus patients were admitted during the 6-year period. Mean age of the patients (9 male, 6 female) was60 ± 13 years. Median length of stay was 42 days (range: 30-77 days) for survivors and 7 days (range: 1-59 days) for non-survivors. Mortality was consequent to severe tetanus in 5 patients, sepsis in 2 patients, and myocardial infarction in 1patient. One patient died due to complications of acute renal failure, and another died due to acute pancreatitis and renal failure. The mortality rate was 66%. Seven patients had nosocomial infections (16 episodes). Ventilator-associated pneumonia was the most common infection, followed by primary bacteremia and urinary tract infection. Conclusion: Although it is preventable with vaccination, tetanus remains a problem, especially for the elderly population.Despite intensive support, the mortality rate in our tetanus patients was high.