التفاصيل البيبلوغرافية
| العنوان: |
Admission of tetanus patients to the ICU: a retrospective multicentre study. |
| المؤلفون: |
Mahieu, Rafael1 rafael.mahieu@chu-angers.fr, Reydel, Thomas1 Thomas.Reydel@chu-angers.fr, Maamar, Adel2 Adel.MAAMAR@chu-rennes.fr, Tadié, Jean-Marc2 jeanmarc.tadie@chu-rennes.fr, Jamet, Angeline3 Angeline.JAMET@chu-poitiers.fr, Thille, Arnaud3 aw.thille@gmail.com, Chudeau, Nicolas4 nchudeau@ch-lemans.fr, Huntzinger, Julien5 julienhuntzinger@hotmail.com, Grangé, Steven6 Steven.Grange@chu-rouen.fr, Beduneau, Gaetan6 gaetan.beduneau@chu-rouen.fr, Courte, Anne7 anne.courte@ch-stbrieuc.fr, Ehrmann, Stephane8 StephanEHRMANN@gmail.com, Lemarié, Jérémie9 J.LEMARIE@chu-nancy.fr, Gibot, Sébastien9 s.gibot@chu-nancy.fr, Darmon, Michael10 michael.darmon@chu-st-etienne.fr, Guitton, Christophe11 cguitton@ch-lemans.fr, Champey, Julia12 JChampey@chu-grenoble.fr, Schwebel, Carole12 CSchwebel@chu-grenoble.fr, Dellamonica, Jean13 DELLAMONICA.J@chu-nice.fr, Wipf, Thibaut14 th.wipf@gmail.com |
| المصدر: |
Annals of Intensive Care. 11/7/2017, Vol. 7 Issue 1, p1-7. 7p. |
| مصطلحات موضوعية: |
*TETANUS, *INTENSIVE care units, *ARTIFICIAL respiration, *MECHANICAL ventilators, *OLDER patients, *PROGNOSIS, *COMORBIDITY |
| مستخلص: |
Background: An extended course of tetanus (up to 6 weeks) requiring ICU admission and protracted mechanical ventilation (MV) may have a significant impact on short- and long-term survival. The subject is noteworthy and deserves to be discussed. Methods: Twenty-two ICUs in France performed tetanus screenings on patients admitted between January 2000 and December 2014. Retrospective data were collected from hospital databases and through the registers of the town hall of the patients. Results: Seventy patients were included in 15 different ICUs. Sixty-three patients suffered from severe or very severe tetanus according to the Ablett classification. The median age was 80 years [interquartile range 73-84], and 86% of patients were women. Ninety per cent of patients ( n = 63) required MV for a median of 36 days [26-46], and 66% required administration of a neuromuscular-blocking agent for 23 days [14-29]. A nosocomial infection occurred in 43 patients (61%). ICU and 1-year mortality rates were 14% ( n = 10) and 16% ( n = 11), respectively. Forty-five per cent of deaths occurred during the first week. Advanced age, a higher SAPS II, any infection, and the use of vasopressors were significantly associated with a lower number of days alive without ventilator support by day 90. Age was the only factor that significantly differed between deceased and survivors at 1 year (83 [81-85] vs. 79 [73-84] years, respectively; p = 0.03). Sixty-one per cent of survivors suffered no impairment to their functional status. Conclusion: In a high-income country, tetanus mainly occurs in healthy elderly women. Despite prolonged MV and extended ICU length of stay, we observed a low 1-year mortality rate and good long-term functional status. [ABSTRACT FROM AUTHOR] |
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