Chest tube thoracotomy indications and early complications among patients with chest pathology at Mulago National Referral Hospital: a cohort study.

Abstract

Introduction: Chest tube thoracostomy (CTT) is defined as the insertion of a chest tube into the pleural cavity to drain air, blood, bile, pus, or other fluids. CTT is the most commonly performed lifesaving surgical procedure in thoracic surgery with the indication in the management of traumatic and non-traumatic chest pathologies. However, being invasive it has potential complications which could make it fatal and life-threatening. The objective of the study: To determine the indications of CTT, early chest tube thoracostomy complications, and associated risk factors among chest pathology patients in MNRH. Methods of study: The study was a prospective cohort study that reviewed 90 participants in a period of three months. It was conducted at MNRH focusing on patients with chest pathology and with chest tube thoracostomy. The main ward of focus was CTS ward and wards; 16c, TB, casualty, and acute care as other sub-units. Results; 90 participants were evaluated, the prevalence of CTT complications was 41.1% at MNRH, male to female ratio was 2:1 and the mean age of the participants was 28 years. 63.3% of chest pathology was due to trauma while 36.7 % was none traumatic. The commonest indication of CTT was hemothorax (31.1%), pneumo-hemothorax 15%, and pleural effusion, and lastly pneumothorax. 32.4% of the complications were due to infection, 29.7% were due to blocked drain, 21.6% were due to residual pneumothorax/effusion. Participants who had symptoms for 7 days and more were 5 times more likely to get complications following CTT. Conclusion; Hemothorax and pleural effusion were the leading indications of CTT. Infection complications and blocked drains on the other hand were the most common early complications of CTT, with symptoms of over seven days causing five-time risk of developing complications.