Aggressive Intensive Care Treatment of Very Elderly Patients with Tetanus Is Justified: RESULTS
According to previous studies showing an increased mortality in elderly patients, we divided the study group according to age (Tables 2 and 3). There was no difference between groups in terms of duration of intubation, hospital stay, and frequency of cardiovascular complications. Infectious complications were fairly common in both groups. Two patients died: a 63-year-old woman developed fatal peritonitis due to a perforated duodenal ulcer after 14 days in the intensive care unit; and a 45-year-old woman presented with severe and protracted hypotension that resulted in massive cerebral infarction and death on the 180th day. The eight other patients all experienced uneventful recovery, without any sequelae upon hospital discharge.
Table 2—Patients with Generalized Tetanus Younger Than 70 Years of Age
|
|
Admission |
Intubation |
Hospital |
Cardiovascular |
|
|
Patient/Age, у |
Year |
(Days) |
(Days) |
Lability |
Complications |
|
1/63 |
1968 |
14 |
14 |
- |
Duodena] ulcer with perforation peritonitis; death |
|
4/45 |
1976 |
180 |
180 |
+ |
Sustained hypotension with cerebral infarction; death |
|
6/44 |
1977 |
45 |
111 |
+ |
Klebsiella |
|
10/23 |
1982 |
9 |
43 |
+ |
None |
|
12/61 |
1987 |
27 |
68 |
+ |
Staphylococcus |
|
Mean ±SD/47.2± 16.1 |
|
55* ±71 |
83* ±65 |
|
|
|
Median/— |
|
27 |
68 |
|
|
Table 3—Patients with Generalized Tetanus 70 Years or Older
levitra 10 mg
|
|
Admission |
Intubation |
Hospital |
Cardiovascular |
|
|
Patient/Age, у |
Year |
(Days) |
(Days) |
Lability |
Complications |
|
3/74 |
1976 |
4 |
50 |
- |
Klebsiella |
|
9/79 |
1982 |
20 |
45 |
+ |
GI bleeding, pneumothorax, |
|
11/85 |
1984 |
55 |
142 |
+ |
Klebsiella |
|
13/83 |
1988 |
90 |
173 |
+ |
None |
|
14/81 |
1989 |
45 |
124 |
+ |
None |
|
Mean ±SD/80.4± 4.2 |
|
43* ±33 |
107* ±.56 |
|
|
|
Median/— |
|
45 |
124 |
|
|
