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Adult patients with tetanus in Slovenia 2006–2021

Results of a national cohort study

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Summary

Introduction

The aim of the present study was to determine the demographic, epidemiological and clinical characteristics of adult patients with tetanus in Slovenia between 2006 and 2021, as well as to determine the therapeutic approaches which have been successfully used in the intensive care unit (ICU) of the Infectious Diseases Department in the University Medical Centre Ljubljana (UMC).

Methods

We included all adult patients who were treated for tetanus in the ICU of the Department of Infectious Diseases Ljubljana between January 1st, 2006, and December 31th, 2021, in the retrospective study. Available epidemiological and clinical characteristics were reviewed from the medical documentation.

Results

There were 31 patients included in the study, four (12.9%) males and 27 (87.1%) females. The vast majority of patients required mechanical ventilation (MV) (87.1%) which lasted (± SD) on average 35.4 ± 16.0 days. Autonomic dysfunction was present in 29 (93.5%) patients and was statistically significantly associated with shorter disease evolution (p = 0.005) and presence of healthcare-associated infection (p = 0.020). During the hospitalization, 27 (87.1%) patients acquired at least one healthcare-associated infection, most commonly ventilator-associated pneumonia. The average length of stay in the ICU (± SD) was 42.5 ± 21.3 days. With increasing age, MV lasted statistically significantly longer (p = 0.001), length of stay was longer (p = 0.015), and healthcare-associated infections occurred (p = 0.003) more frequently. Four patients (12.9%) died.

Conclusions

Although the tetanus incidence rate in Slovenia is high in comparison to other European countries on average, our therapeutic approach resulted in a good survival rate and low mortality.

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Authors and Affiliations

  1. Infectious Diseases Department, University Medical Centre, Japljeva 2, 1000, Ljubljana, Slovenia

    Nina Grasselli Kmet MD, PhD, Igor Muzlovič & Matjaž Jereb

  2. Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

    Nina Grasselli Kmet MD, PhD & Matjaž Jereb

  3. In-Medico, Department of Research and Development, Mestni trg 11, Metlika, Slovenia

    David Štubljar

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  1. Nina Grasselli Kmet MD, PhD
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  2. Igor Muzlovič
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  3. Žiga Martinčič
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  5. Matjaž Jereb
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Corresponding author

Correspondence to Nina Grasselli Kmet MD, PhD.

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Conflict of interest

N. Grasselli Kmet, I. Muzlovič, Ž. Martinčič, D. Štubljar and M. Jereb declare that they have no competing interests.

Ethical standards

The study was approved by the National Medical Ethics Committee of the Republic of Slovenia on 11 October 2022 (consent number 0120-556/2018/12).

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Grasselli Kmet, N., Muzlovič, I., Martinčič, Ž. et al. Adult patients with tetanus in Slovenia 2006–2021. Wien Klin Wochenschr 135, 625–630 (2023). https://doi.org/10.1007/s00508-023-02222-3

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