Abstract：Objective To analyze the epidemiological characteristics of severe tetanus and its death-related risk factors so as to provide a basis for prevention and treatment of tetanus. Methods The data regarding 78 patients with severe tetanus hospitalized in the Fifth Hospital of Shijiazhuang City from June 2008 to June 2018 were retrospectively analyzed, and their epidemiological characteristics, causes of death, and death-related risk factors were also analyzed. Results Among the 78 patients, there were67 male patients and 11 female ones, with an average age of (48.1±16.1) years. 41 (52.6%) cases came from rural areas and 37 (47.4%) cases from urban areas. 33 (42.3%) cases occurred during July-September. 73 (93.6%) cases had traumatic history, and most of them were stabbing injuries caused by nails, glass and knives. The latent period was 5-33 days, with an average of (17.0± 6.9) days. The median interval from symptom onset to hospitalization was 1-20 days, with an average of (6.5±2.0) days. Complications included pneumonia (76.9%), autonomic nervous system dysfunction (66.7%), shock (60.3%), atelectasis (7.7%), acute renal failure (6.4%), pneumothorax (5.1%) and hemorrhage (5.1%). There were 34 deaths, and the mortality rate was 43.6%. Logistic regression analysis indicated that autonomic nervous system dysfunction, continuous neuromuscular blockade, vaccination, Acute Physiology and Chronic Health Evaluation (APACHE) II score and age were death-related risk factors. Conclusions Middle-aged men with a history of trauma are the main population leading to morbidity and mortality of tetanus. Summer is a high-occurrence season for tetanus. Early complete vaccination can reduce the risk of morbidity and mortality. Autonomic nervous system dysfunction, persistent neuromuscular blockade, vaccination, APACHE II score and age can be used to predict the risk of death in patients.
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2020, Vol. 27 
