Prevalence and Factors Associated with Mortality among Chest Injury Patients Admitted at Muhimbili National Hospital in Dar es Salaam, Tanzania

Abstract

Introduction: Accidents represent a significant proportional of non-communicable disease in the current century, and chest injury is common. However, management and outcome of these injuries is poor in low resource setting like Tanzania. The aim of this study was to determine the prevalence and factors associated with mortality among chest injury patients at a tertiary level health facility in Tanzania. Method: A prospective Cross-Sectional study of chest injuries among trauma patients attended at Muhimbili National Hospital between September 2019 and February 2020. Results: A total of 282 trauma patients were seen, out of which 51/282 (18.1%) sustained chest injury. Road Traffic Crashes were the leading cause of chest injury 41/51 (80.4%). Majority 17/51 (33.3%) presented with lung contusion, followed by pneumohemothorax and rib fractures each 8/51 (15.7%). Most of the patients 27/51 (52.9%) were managed by tube thoracostomy and 42.1% conservatively. Mortality was 11/51 (21.6%). Independent factors associated with mortality were: Associated injuries (Odds Ratio (OR) 0.07, 95% CI 0.01 - 1.16, p = 0.02), Multimodal analgesia (Odds Ratio (OR) 0.22, 95% CI 0.05 - 0.98, p = 0.05), more than 24 hours to treatment (Odds Ratio (OR) 5.53, 95% CI 1.25 - 24.3, p = 0.02), Bilateral chest involvement (Odds Ratio (OR) 4.61, 95% CI 1.12 - 18.7, p = 0.02), and Invasive ventilation (Odds Ratio (OR) 31.5, 95% CI 4.47 - 53.8, p = 0.00). Conclusion: Chest injuries prevail significantly among trauma patients in Tanzania, mostly due to road traffic crashes. Injury preventive measures especially for road traffic crashes need to be reinforced, and establishment of chest injury management protocol in Tanzania.