Five hundred consecutive patients with tetanus: Centre for Tropical Diseases, Ho Chi Minh City
| Demographic: | |||
|---|---|---|---|
| 500 Consecutive non-neonatal patients admitted between May 1997 and February 1999. | |||
| 343 Male | 157 Female | ||
| Age<15 years | 18.8% | ||
| Age>65 years | 12.2% | ||
| 39 Neonates were admitted in the same time period | |||
| Mortality in non-neonates | 19% | ||
| Mortality in neonates | 45% | ||
| Entry site: | |||
| Lower limb | 53.3% | Head | 10.4%. |
| Upper limb | 10.8% | Injections | 1.8%. |
| Unknown: | 22.2%. | ||
| Incubation period | Median (range) | 9.5 days (1–60) | |
| Time to first symptom | Median (range) | 3 days (1–92) | |
| Period of onset | Median (range) | 48 hours (0–264) | |
| Symptoms on admission: | |||
| Lockjaw | 96% | Spasms | 41% |
| Back pain | 94% | Sweating | 10% |
| Muscle stiffness | 94% | Difficulty breathing | 10% |
| Dysphagia | 83% | Fever | 7% |
| Admission severity scores and mortality rates: | |||
| Dakar score | Mortality | Phillips score | Mortality |
| ⩾3 | 35/59 (59%). | ⩾17 | 58/170 (34%). |
| <3 | 60/440 (14%). | <17 | 38/330 (11%). |
| RR 4.35 (3.17–5.97) | RR 2.96 (2.06–4.27) | ||
| By combining the Dakar and Phillips scores in individual patients: | |||
| Dakar ⩾3 and Phillips ⩾17 compared with Dakar <3 and Phillips <17 | |||
| RR 3.68 (2.49–5.45) | |||
RR = Relative risk.