Management and outcome of adult generalized tetanus patients in a tertiary hospital in Anhui, China: a retrospective study

Background Tetanus is an acute, specific infectious disease associated with a high reported mortality rate and remains a major public health problem, particularly in low and middle-income countries. This study analyzes the epidemiological and clinical characteristics of adult tetanus patients admitted to our hospital to provide a basis for clinical treatment and prognosis. Methods We conducted a retrospective analysis of the clinical data from 54 patients with tetanus admitted to a tertiary infectious disease hospital between January 1, 2018, and December 31, 2024. Disease severity was classified using the Ablett classification, which served as the primary grouping variable to categorize patients into the severe group and non-severe group. We analyzed the timing of patient presentation, cause of injury, trauma site, wound treatment prior to admission, disease classification, length of hospital stay, hospitalization costs, and mortality rate. Results The mean age of 54 patients were 62.76 ± 12.69 years. The cohort included 30 male patients (55.56%) and 24 female patients (44.44%), with 51 patients (94.44%) from rural areas and 3 (5.56%) from urban areas. The mean hospital stay was 22.22 ± 13.38 days, the mean hospitalization cost was 67,297.44 ± 68,431.91 yuan, and 7 patients died (12.96%). A comparison of the treatment course between the non-severe and severe groups revealed statistically significant differences in several outcomes. The severe group had higher rates of ICU admission 0% (0/25) vs. 96.55% (28/29); χ 2 = 50.131, p 0.001, mechanical ventilation 0% (0/25) vs. 89.66% (26/29); χ 2 = 46.552, p 0.001, and pulmonary infection 28.00% (7/25) vs. 96.55% (28/29); χ 2 = 27.666, p 0.001. Furthermore, the severe group had a longer hospital stay 28.44 ± 14.82 days vs. 15.00 ± 6.16 days; t = −4.461, p 0.001 and higher hospitalization costs (115,236.04 ± 60,894 yuan vs. 11,688.66 ± 4,145.69 yuan; t = −9.133, p 0.001). Conclusion Tetanus remains prevalent in rural areas and disproportionately affects older adults. Patients in the severe disease group experience substantial economic burden and higher mortality. Strengthening public awareness, improving wound care, and expanding immunization coverage, especially among rural older adults, are critical to reducing the disease burden.