Head and Neck Symptoms as Predictors of Outcome in Tetanus Patients

Authors

  • Angeli C. Carlos-Hiceta, MD Department of Otorhinolaryngology Philippine General Hospital University of the Philippines Manila
  • Ryner Jose D. Carrillo, MD, MSc Department of Anatomy, College of Medicine, University of the Philippines Manila; Department of Otorhinolaryngology College of Medicine – Philippine General Hospital University of the Philippines Manila
  • Jose Florencio F. Lapeña, Jr., MA, MD Department of Otorhinolaryngology College of Medicine – Philippine General Hospital University of the Philippines Manila https://orcid.org/0000-0002-5794-1878

DOI:

https://doi.org/10.32412/pjohns.v35i2.1519

Keywords:

tetanus, head and neck symptoms, outcome, predictors of outcome, trismus, neck pain/ rigidity, tracheotomy

Abstract

ABSTRACT

Objective: This study aims to investigate which, if any head and neck symptoms (trismus, dysphagia, alterations in speech or facial movements, and dyspnea) might be good predictors of outcomes (mortality, tracheostomy, discharged, decannulated) and prognosis of tetanus patients.

Methods:
Design: Retrospective Cohort Study
Setting: Tertiary National University Hospital
Patients: Seventy-three (73) pediatric and adult patients diagnosed with tetanus and admitted at the emergency room of the Philippine General Hospital between January 1, 2013 and December 31, 2017. Demographic characteristics, incubation periods, periods of onset, routes of entry, head and neck symptoms, stage, and outcomes were retrieved from medical records and analyzed.

Results: Of the 73 patients included, 53 (73%) were adults, while the remaining 20 (27%) were pediatric. The three most common head and neck symptoms were trismus (48; 66%), neck pain/ rigidity (35; 48%), and dysphagia to solids (31; 42%). Results of multivariate logistic regression analysis showed that only trismus (OR = 3.742, p = .015) and neck pain/ rigidity (OR = 4.135, p = .015) were significant predictors of decannulation. No dependent variable/symptoms had a significant effect in predicting discharge and mortality.

Conclusion: Clinically diagnosed tetanus can be easily recognized and immediately treated. Most of the early complaints are head and neck symptoms that can help in early diagnosis and treatment resulting in better prognosis. In particular, trismus and neck pain/rigidity may predict the outcome of decannulation after early tracheotomy, but not of discharge and mortality.

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Published

2020-12-01

How to Cite

1.
Carlos-Hiceta A, Carrillo RJ, Lapeña JF. Head and Neck Symptoms as Predictors of Outcome in Tetanus Patients. Philipp J Otolaryngol Head Neck Surg [Internet]. 2020 Dec. 1 [cited 2024 Nov. 21];35(2):32. Available from: https://pjohns.pso-hns.org/index.php/pjohns/article/view/1519

Issue

Vol. 35 No. 2 (2020): Philippine Journal of Otolaryngology-Head and Neck Surgery

Section

Original Articles

License

Copyright transfer (all authors; where the work is not protected by a copyright act e.g. US federal employment at the time of manuscript preparation, and there is no copyright of which ownership can be transferred, a separate statement is hereby submitted by each concerned author). In consideration of the action taken by the Philippine Journal of Otolaryngology Head and Neck Surgery in reviewing and editing this manuscript, I hereby assign, transfer and convey all rights, title and interest in the work, including copyright ownership, to the Philippine Society of Otolaryngology Head and Neck Surgery, Inc. (PSOHNS) in the event that this work is published by the PSOHNS. In making this assignment of ownership, I understand that all accepted manuscripts become the permanent property of the PSOHNS and may not be published elsewhere without written permission from the PSOHNS unless shared under the terms of a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) license.