Tetanus in the elderly: is it different from that in younger age groups?

Our aims were to itemize the clinical features and the outcome of tetanus in the elderly, as well as any age and sex differences in its acquisition. Therefore, we compared the demographic and clinical data of 12 elderly (group 1) cases of tetanus with 69 middle-aged patients (group 2) and 12 children (group 3) suffering from the same disease. There was no significant difference between the site of entry and incubation period or in the clinical and paraclinical findings among the three groups of patients. Acute respiratory failure was found more commonly in group 1 than in groups 2 and 3 (p = 0.0167 and p = 0.0006, respectively). It was also more common in group 2 than in group 3 (p = 0.0140). A mild form of tetanus was more often detected in children than in middle-aged and elderly cases (p = 0.0213 and p = 0.0013, respectively). Severe tetanus was seen more often in group 1 than in groups 2 and 3 (p = 0.0167 and p = 0.0006, respectively). Despite this, the mortality rate was not statistically different among the three groups of patients. Females were affected much less frequently than males with a female:male ratio of 1:3 in all three age groups. Our results suggest that elderly patients are at higher risk of acquiring a more severe form of tetanus and the subsequent development of acute respiratory failure. In addition, the disease is more common in males of all age groups, and age and sex have no apparent effect on the outcome of patients with tetanus.