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

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 31^st 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 (X²=4.57, F.E=0.046), complications (X²=36.82, F.E=0.000) and severe head injury (X2=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.