Mortality rate and factors associated with death in traumatic chest injury patients: A retrospective study

Abstract

BackgroundTraumatic chest injury is responsible for 10%–15% of all trauma-related hospital admissions across the world. It is also responsible for approximately 25% of trauma related death. Several predictors have been described for mortality following chest trauma however, limited published studies were available in Ethiopia. ObjectiveTo assess mortality rate and factors associated with death in traumatic chest injury patients over five year's period from June 2016 to June 30, 2020 G.C. MethodA retrospective cross-sectional study was done from June 2016 to June 30, 2020. Data was collected from patients’ chart. The collected data was entered into Epi-info version 7 and transferred to SPSS version 20.0 for processing and analysis. Bivariable and multivariable logistic regression was used to show factors associated with mortality. P- Value < 0.05 was considered statistically significant. ResultA total of 419 patient charts were eligible for this study. The majority of patients (55.8%) sustained blunt chest injuries and violence (52.5%) was the leading cause of injuries. Hemopneumothorax (27.7.0%), hemothorax (22.9%) and rib fracture (17.2%% were the most common type of injuries. Associated extra-thoracic injuries were noted in 70.4% of patients, from those, extremity injury (22.2%), head/neck injuries (21.7%) and abdominal injuries (18.1%) were the commonest. Most patients (64.7%) were treated successfully with chest tube. Nearly, one third (35.3%) had complications including pneumonia (13.8%) and Atelectasis (12.6%). The mean length of hospital stay was 9.40 days. The overall traumatic chest injury mortality rate was 26%. Mortality was significantly associated with age >50 year [AOR 9.32, 95% CI, 2.72–31.86], late presentation beyond 6hr (AOR 7.17, 95% CI 1.76–29.21), bilateral chest injury (AOR 3.58 95% CI 1.53–8.38), penetrating chest injury (AOR 3.63 95% CI 1.65–7.98), presence of extra-thoracic injury (AOR 4.80, 95% CI, 1.47–15.72) and need for mechanical ventilation (AOR 11.18, 95% CI 2.11–59.23). ConclusionThe mortality rate in traumatic chest injury was high. Late presentation beyond 6hr, age >50-year, penetrating injury, bilateral chest injury, associated extra thoracic injury, and need for mechanical ventilation were identified as possible risk factors for mortality in traumatic chest injury patients.