Functional outcome and muscle wasting in adults with tetanus

• Published in: Transactions of the Royal Society of Tropical Medicine and Hygiene 2019-11, Vol.113 (11), p.706-713
• Main Authors: Trung, Truong N, Duoc, Nguyen V T, Nhat, Le T H, Yen, Lam M, Hao, Nguyen V, Truong, Nguyen T, Duong, Ha T H, Thuy, Duong B, Phong, Nguyen T, Tan, Le V, Puthucheary, Zudin A, Thwaites, C Louise
• Format: Article
• Language: English
• Subjects: Adult; Critical Illness; Follow-Up Studies; Hospitalization - statistics & numerical data; Humans; Male; Middle Aged; Muscle Weakness - etiology; Muscle Weakness - physiopathology; Original; Prospective Studies; Tetanus - complications; Tetanus - physiopathology; Time Factors
• ISSN: 0035-9203; 1878-3503
• DOI: 10.1093/trstmh/trz055

Abstract Background In many countries, in-hospital survival from tetanus is increasing, but long-term outcome is unknown. In high-income settings, critical illness is associated with muscle wasting and poor functional outcome, but there are few data from resource-limited settings. In this study we aimed to assess muscle wasting and long-term functional outcome in adults with tetanus. Methods In a prospective observational study involving 80 adults with tetanus, sequential rectus femoris ultrasound measurements were made at admission, 7 days, 14 days and hospital discharge. Functional outcome was assessed at hospital discharge using the Timed Up and Go test, Clinical Frailty Score, Barthel Index and RAND 36-item Short Form Health Survey (SF-36) and 3 and 6 months after discharge using the SF-36 and Barthel Index. Results Significant muscle wasting occurred between hospital admission and discharge (p70 y of age, functional recovery at 6 months was reduced compared with younger patients. Hospital-acquired infection and age were risk factors for muscle wasting. Conclusions Significant muscle wasting during hospitalization occurred in patients with tetanus, the extent of which correlates with functional outcome.