Clinical features and outcomes of tetanus: Analysis using a National Inpatient Database in Japan
Clinical features and outcomes of tetanus: Analysis using a National Inpatient Database in Japan
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DOI：
10.1016/j.jcrc.2017.12.025
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发表时间：
2018-04-01
影响因子：
3.7
通讯作者：
Yasunaga, Hideo
中科院分区：
文献类型：
--
作者：
Nakajima, Mikio;Aso, Shotaro;Yasunaga, Hideo
目的：本研究是为了阐明目前的临床特点和结果破伤风使用国家住院databaseinJapanes.Materials和方法：我们使用日本诊断程序组合住院数据库，回顾性调查破伤风患者从2010年7月至2016年3月。我们检查了患者的特点;需要气管插管，机械通气和气管造口术的患者的比例;和出院status.Results：我们确定了499例确诊为破伤风的患者。没有患者被诊断为破伤风或产科破伤风。中位年龄为74岁。总体而言，53.5%的患者需要插管和机械通气。在需要插管和机械通气的患者中，80.6%在入院后3天内开始，77.5%在住院期间需要气管切开。机械通气的中位持续时间为23天。平均住院时间为35天。出院回家的患者比例为58.1%，出院到家以外的其他地方的患者比例为35.1%。结论：重症监护医师应随时准备为破伤风患者提供重症监护，并与医务社会工作者和家属合作，做好后续的长期护理。(C)2017爱思唯尔公司All rights reserved.
Purpose: This study was performed to elucidate the current clinical features and outcomes of tetanus using a national inpatient database in Japan.Materials and methods: We used the Japanese Diagnosis Procedure Combination inpatient database to retrospectively investigate patients with tetanus from July 2010 to March 2016. We examined the patients' characteristics; the proportions of patients requiring tracheal intubation, mechanical ventilation, and tracheostomy; and the discharge status.Results: We identified 499 patients who were diagnosed with tetanus. No patient had a diagnosis of tetanus neonatorum or obstetric tetanus. The median age was 74 years. Overall, 53.5% of the patients required intubation and mechanical ventilation. Among patients who required intubation and mechanical ventilation, 80.6% started it within 3 days of admission, and 77.5% required tracheostomy during hospitalization. The median duration of mechanical ventilation was 23 days. The median length of hospitalization was 35 days. The proportions of patients who were discharged to home and to locations other than home were 58.1% and 35.1%, respectively. The in-hospital mortality was 6.8%.Conclusion: The present study suggests that acute-care physicians should be ready to provide intensive care for patients with tetanus and cooperate with medical social workers and families for subsequent long-term nursing care. (C) 2017 Elsevier Inc. All rights reserved.