Dissertation (MMed General Surgery)
Background: Chest injuries are among the commonest injuries worldwide, of which the most associated injuries are haemothorax, pneumothorax and haemopneumothorax mostly due to RTC, the productive age male being the most victims. This agrees with my study. In my study, unemployment and low education level have been the most causes. Though some respondents died but a few patients were saved by tube thoracostomy and the use of steroid drugs.
Objectives: The aim of the study was to determine the causes and early management outcomes of hemothorax, pneumothorax and hemopneumothorax in Dodoma City and Iringa Municipality Hospitals.
Methods: This was a hospital based prospective descriptive cross – sectional study which enrolled 95 respondents with hemothorax and or pneumothorax out of 232 respondents with chest injuries, all from Dodoma City and Iringa Municipality Hospitals. Questionnaires were used to collect data on demographic data, causes mechanism of injuries, comorbidities, associated injuries, investigations and early management outcomes. Patients were followed for the maximum of 28 days. Data analysis was done using SPSS version 20. Relationships were tested using Chi-square at 5% tolerable error. The Odds of occurrences were tested using the Odds Ratio (OR) at 95% Confidence Interval (95% CI).
Results: Out of 232 patients, 40.9% had hemothorax and or pneumothorax mostly due to RTC (68.1%), majority being the males of productive age less than 25 years accounting for 31.9% of all. Blunt mechanism of injury was leading (87.7%). The commonest causes were low education level by a P- value of less than 0.001 and unemployment by the p-value of less than 0.001. The majority of patients who sustained haemothaorax, pneumothoarax and haemopneumothorax were residing in urban by p – value of less than 0.001. Some of the treatment modalities which were helpful were tube thoracostomy and steroid drugs by the p-value of less than 0.001. The association of hemothorax and or pneumothorax as far as types of chest injuries were concerned had p- value of 0.005 which is statistically significant.
Conclusion: The study shows that majority of patients out of 232 patients 70 (30.2%) died. Those respondents who died with Hemothorax and or pneumothorax were 32 (33.7%) out of 70 deaths. As far as types of chest injuries are concerned, hemothorax and or pneumothorax have a p- value of 0.005 which is statistically significant.