Prevalence, Pattern, and Management Outcomes of Chest Injury at Kilimanjaro Christian Medical Centre

Abstract

Background: Chest trauma is a major cause of morbidity and mortality in the region. Lacking data in our environment has been a challenging part of knowing the burden of the problem. Long hospital stays and associated injuries are an essential measure of morbidity. The study results will provide a basis for planning prevention strategies and establishment of treatment protocols. Objectives: To determine the prevalence, pattern, and management outcomes of chest injury patients at Kilimanjaro Christian Medical Center (KCMC), a Tertiary Hospital in Northern zone Tanzania from October 2021 to April 2022. Methodology: A hospital-based cross-sectional study was conducted among patients with chest injuries who were admitted and managed at Tertiary Hospital Northern Zone (Kilimanjaro Christian Medical Center-KCMC) in the Emergency medicine and General Surgery departments. Using a designated data collection tool, details of the mechanism of injury, radiological and laboratory investigations, management, and outcomes were recorded. Results: A total of 114 chest injury patients were studied. Males outnumbered females by a ratio of 7.14:1. Their ages ranged from 2 to 83 years (mean = 36.18 years). The Majority of patients (95.58%) sustained blunt injuries. Road traffic crush was the most common cause of injuries affecting 65.79% of patients. Lung contusion, hemothorax, and rib fractures were the most common type of injuries accounting for 54.4%, 27.2%, and 21.1%, respectively. Associated injuries were noted in 85.7% of patients, and head injury (60.5%) was found in most patients. The Majority of patients (60.5%) were treated successfully with a non-operative approach. Underwater seal drainage was performed at (38.9%). One Patient (0.9%) underwent a thoracotomy. 14% of patients had complications of surgical site infection, and 69% were found in the Majority of patients. The median length of hospital stay was 4.5 days. The mortality rate was 21% Conclusion: Motor traffic crash was the principal cause of chest trauma. Young male patients were most affected by chest trauma and the majority of patients were treated conservatively. Chest X-ray remains to be the main imaging modality for diagnosing thoracic trauma lesions. Associated injuries such as head injuries, were found to contribute to a high mortality rate.

Mortality of traumatic chest injury and its predictors across sub-saharan Africa: systematic review and meta-analysis, 2024

“…The pooled effect of four studies [ 26 , 34 , 39 , 40 ] revealed that individuals aged over 50 had 3.5 times higher odds (AOR 3.5; 95% CI: 1.19, 10.35) of mortality compared to those under 20. Similarly, the combined findings of three studies [ 26 , 39 , 40 ] indicated that a time interval between injury and admission of 2–6 h was associated with 3.9 times higher odds of mortality (AOR 3.9; 95% CI: 2.04, 7.51) compared to admission within less than 2 h. Additionally, the amalgamated results of three studies [ 26 , 31 , 40 ] demonstrated that associated injuries with the head and neck carried six times higher odds of mortality (AOR 6.28; 95% CI: 3.00, 13.15) than their counterparts. Furthermore, the combined effect of two studies [ 26 , 40 ] showed that associated spinal injuries were associated with 7.8 times higher odds of mortality (AOR 7.86; 95% CI 3.02, 19.51) compared to cases without spinal injuries.…”

“…Of these 21 published original studies that reported the proportion of mortality, four were conducted in Ethiopia [ 26 , 29 , 39 , 40 ], and the majority of studies (nine) were conducted in Nigeria [ 4 , 25 , 27 , 28 , 33 – 37 ]. The other studies were conducted in Tanzania (three) [ 30 , 31 , 43 ], South Africa (two) [ 41 , 42 ], Cameroon (one) [ 32 ], Senegal (one) [ 44 ], and Sudan (one) [ 38 ]. Most studies were conducted with a cross-sectional design (thirteen) [ 4 , 25 – 27 , 29 , 31 , 32 , 36 , 39 – 42 , 44 ], and the fewest were conducted via prospective cohort studies (eight) [ 28 , 30 , 33 – 35 , 37 , 38 , 43 ].…”

“…The other studies were conducted in Tanzania (three) [ 30 , 31 , 43 ], South Africa (two) [ 41 , 42 ], Cameroon (one) [ 32 ], Senegal (one) [ 44 ], and Sudan (one) [ 38 ]. Most studies were conducted with a cross-sectional design (thirteen) [ 4 , 25 – 27 , 29 , 31 , 32 , 36 , 39 – 42 , 44 ], and the fewest were conducted via prospective cohort studies (eight) [ 28 , 30 , 33 – 35 , 37 , 38 , 43 ]. The sample size of each study ranged between 40 and 442.…”