학술논문
Risk factors associated with mechanical ventilation, autonomic nervous dysfunction and physical outcome in Vietnamese adults with tetanus
Document Type
article
Author
Rachel Davies-Foote; Truong Ngoc Trung; Nguyen Van Thanh Duoc; Du Hong Duc; Phung Tran Huy Nhat; Vo Thi Nhu Trang; Nguyen Thi Kim Anh; Pham Thi Lieu; Duong Bich Thuy; Nguyen Thanh Phong; Nguyen Thanh Truong; Pham Ba Thanh; Dong Thi Hoai Tam; Tran Thi Diem Thuy; Pham Thi Tuyen; Thanh Tran Tan; James Campbell; Le Van Tan; Zudin Puthucheary; Lam Minh Yen; Nguyen Van Hao; C. Louise Thwaites
Source
Tropical Medicine and Health, Vol 49, Iss 1, Pp 1-9 (2021)
Subject
Language
English
ISSN
1349-4147
Abstract
Abstract Background Tetanus remains common in many low- and middle-income countries, but as critical care services improve, mortality from tetanus is improving. Nevertheless, patients develop severe syndromes associated with autonomic nervous system disturbance (ANSD) and the requirement for mechanical ventilation (MV). Understanding factors associated with worse outcome in such settings is important to direct interventions. In this study, we investigate risk factors for disease severity and long-term physical outcome in adults with tetanus admitted to a Vietnamese intensive care unit. Methods Clinical and demographic variables were collected prospectively from 180 adults with tetanus. Physical function component scores (PCS), calculated from Short Form Health Survey (SF-36), were assessed in 79 patients at hospital discharge, 3 and 6 months post discharge. Results Age, temperature, heart rate, lower peripheral oxygen saturation (SpO2) and shorter time from first symptom to admission were associated with MV (OR 1.03 [ 95% confidence interval (CI) 1.00, 1.05], p = 0.04; OR 2.10 [95% CI 1.03, 4.60], p = 0.04; OR 1.04 [ 95% CI 1.01, 1.07], p = 0.02); OR 0.80 [95% CI 0.66, 0.94], p = 0.02 and OR 0.65 [95% CI 0.52, 0.79, p