Letalidade e complica？？es osteomusculares e cardiovasculares no tétano

objective: despite the decline in the incidence of tetanus, this disease is still neglected in the developing world and remains a major cause of morbidity and mortality. with improvements in intensive care, it is important to better understand the complications of this serious condition. we aim to evaluate 1) the lethality and osteomuscular and cardiovascular complications of patients with tetanus who are admitted to the intensive care unit (icu) and 2) the risk factors associated with a poor prognosis. methods: this was a retrospective study that analyzed the medical records of all of the patients diagnosed with tetanus who were admitted to an infectious diseases icu between january 2000 and december 2001. a standardized form that included demographic, clinical and laboratory data was completed. the clinical variables that were related to lethality and osteomuscular and cardiovascular complications were described. results: a total of 22 tetanus patients were admitted (81.8% male, mean age of 47.8 years).the tetanus infection was associated with professional activities in 54.5% of cases. the majority of patients (20 patients) presented with the generalized form of disease. eighty-one percent of the patients had never received a tetanus vaccine or were unaware of their vaccine status. following the injury, none had received appropriated passive prophylaxis, only two patients had received surgical debridement of wound and six patients received antibiotic therapy. eleven patients (52.4%) experienced some cardiovascular complication. a pressure ulcer was the most frequent cardiovascular complication (38.1%), followed by arrhythmias (28.6%). two of the patients developed bone fractures secondary to tetanus spasms, corresponding to 9.6% of sample. the tetanus lethality rate was 9.1%. higher apache ii severity scores and very severe status based on the veronesi tetanus classification were significantly associated with the risk of death (p=0.04 and 0.03, respectively). the