| Summary: | OBJECTIVES: Most data regarding prognosis in neonatal tetanus originates from regions where limited resources have historically impeded management. It is not known whether recent improvements in critical care facilities in many low and middle income countries have affected indicators of poor prognosis in neonatal tetanus. We aimed to determine the factors associated with worse outcome in a Vietnamese hospital with neonatal intensive care facilities. METHODS: Data was collected from 107 cases of neonatal tetanus. Clinical features on admission were analyzed against mortality and a combined endpoint of 'death or prolonged hospital stay'. RESULTS: Multivariable analysis showed that only younger age (OR for mortality 0.69, 95% CI 0.48 to 0.98) and lower weight (OR for mortality 0.06, 95% CI 0.01 to 0.54) were significantly associated with both the combined end point and death. Shorter period of onset (OR 0.94 95% CI 0.9 to 0.97), raised white cell count (OR 1.17, 95% CI 1.02 to 1.35), and time between first symptom and admission (OR 3.77, 95% CI 1.14 to1 2.51) were also indicators of mortality. CONCLUSIONS: Risk factors for poor outcome in neonatal tetanus in a setting with critical care facilities include younger age, lower weight, delay in admission and leukocytosis.
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