Journal article
Functional outcome and muscle wasting in adults with tetanus
- Abstract:
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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.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
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(Preview, Version of record, 390.0KB, Terms of use)
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- Publisher copy:
- 10.1093/trstmh/trz055
Authors
- Publisher:
- Oxford University Press
- Journal:
- Transactions of the Royal Society of Tropical Medicine and Hygiene More from this journal
- Volume:
- 113
- Issue:
- 11
- Pages:
- 706–713
- Publication date:
- 2019-07-24
- Acceptance date:
- 2019-06-04
- DOI:
- EISSN:
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1878-3503
- ISSN:
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0035-9203
- Pmid:
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31340037
- Language:
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English
- Keywords:
- Pubs id:
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pubs:1036485
- UUID:
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uuid:61b7a6a8-a384-46b6-9b0f-030e783a643f
- Local pid:
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pubs:1036485
- Source identifiers:
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1036485
- Deposit date:
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2019-08-12
Terms of use
- Copyright holder:
- Trung, TN et al.
- Copyright date:
- 2019
- Rights statement:
- © The Author(s) 2019. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
- Licence:
- CC Attribution (CC BY)
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