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- Title
Functional outcome and muscle wasting in adults with tetanus.
- 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
- 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 (p<0.01), particularly in severe disease, where a median 23.49% (interquartile range 10.01–26.07) reduction in rectus femoris cross-sectional area occurred in those with severe (Ablett grades 3 and 4) disease. Muscle mass at discharge was related to objective and subjective measures of physical and emotional function at discharge and 3 and 6 months after discharge. In patients >70 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.
- Subjects
RECTUS femoris muscles; HOSPITAL admission &; discharge; TETANUS; NOSOCOMIAL infections; MUSCLES; BARTHEL Index
- Publication
Transactions of the Royal Society of Tropical Medicine & Hygiene, 2019, Vol 113, Issue 11, p706
- ISSN
0035-9203
- Publication type
Article
- DOI
10.1093/trstmh/trz055