Patterns and Short Term Outcomes of Chest Injuries at Mbarara Regional Referral Hospital in Uganda

East and Central African Journal of Surgery Pub Date : 2017-01-23 DOI:10.4314/ecajs.v21i3.6

M. Mwesigwa, D. Bitariho, D. Twesigye

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引用次数: 4

Abstract

Background: This study was conducted to establish the causes, injury patterns and short-term outcomes of chest injuries at Mbarara Regional Referral Hospital. Methods: This was a prospective study involving chest injury patients admitted to Mbarara Regional Referral Hospital (MRRH) for a period of one year from April 2014 to 31st March 2015. Results: A total of 71 chest injury patients were studied. Males (91.6%) were the majority and the ages ranged from 8 to 76 years (mean 32.9 years (+/- 14.0). Majority of the patients (57.7%) sustained blunt injury. RTA was the most common cause of injury, affecting 49.3%.The commonest injury patterns were chest wall injuries and lung and pleural injuries accounting for 69.0% and 64.8 respectively. Rib fractures were the commonest chest wall injury (71.4%) while hemopneumothorax was the commonest (34.9%) finding among those with lung and pleural injury. Associated injuries were found in 64.2% and out of these, abdominal injuries were the commonest extra thoracic injury (39.1%) followed by head injury(37.0%),cuts and lacerations(37%) andfractures (28.3%).The commonest abdominal organs injured were spleen(44.4%), liver (27.8%) and stomach (16.7%). Majority of the patients had thoracostomy (47.9%) while 33.8% had non surgical treatment. Laparotomy and thoracotomy were done in 11(15.5%) and 3 (4.2%) of the patients respectively. Complications occurred in 20(28.2%) and the commonest complication was pneumonia 6 (30%).The mean length of stay was 7.14 days, SD=±6.1) and the mortality was 16.9%.The significant determinants of mortality were associated injuries (X 2 =4.57, F.E=0.046), complications (X 2 =36.82, F.E=0.000) and severe head injury (X 2 =13.85, F.E=0.001). Conclusion: The causes, patterns and short-term outcomes of this study are similar to those observed in other developing countries. Chest injury in our setting causes high mortality and measures to reduce road traffic accidents are urgently required. Key words : Chest injury, pattern, outcomes

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乌干达姆巴拉拉地区转诊医院胸部损伤的模式和短期结果

背景:本研究旨在确定姆巴拉拉地区转诊医院胸部损伤的原因、损伤模式和短期预后。方法:这是一项前瞻性研究，涉及2014年4月至2015年3月31日在Mbarara地区转诊医院(MRRH)住院的胸部损伤患者，为期一年。结果:共对71例胸部损伤患者进行了研究。男性占91.6%，年龄8 ~ 76岁，平均32.9岁(±14.0岁)。绝大多数患者(57.7%)为钝性损伤。RTA是最常见的损伤原因，占49.3%。最常见的损伤类型为胸壁损伤和肺胸膜损伤，分别占69.0%和64.8%。胸壁损伤以肋骨骨折最常见(71.4%)，肺气胸最常见(34.9%)。其中，腹部损伤是最常见的胸外损伤(39.1%)，其次是头部损伤(37.0%)、割伤和撕裂伤(37%)和骨折(28.3%)。最常见的腹部脏器损伤为脾脏(44.4%)、肝脏(27.8%)和胃(16.7%)。以开胸手术为主(47.9%)，非手术治疗占33.8%。剖腹和开胸分别为11例(15.5%)和3例(4.2%)。并发症20例(28.2%)，最常见的并发症为肺炎6例(30%)。平均住院时间7.14天(SD=±6.1)，病死率16.9%。死亡率的重要决定因素是相关损伤(x2 =4.57, F.E=0.046)、并发症(x2 =36.82, F.E=0.000)和严重头部损伤(x2 =13.85, F.E=0.001)。结论:本研究的原因、模式和短期结果与在其他发展中国家观察到的相似。在我们的环境中，胸部受伤造成高死亡率，迫切需要采取措施减少道路交通事故。关键词:胸部损伤，模式，结局

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East and Central African Journal of Surgery

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