Tube Thoracostomy Outcomes and Associated Factors among Patients Treated for Chest Injuries in Asella Referral Teaching Hospital, Asella, Ethiopia

Abstract

ABSTRACT Background: Chest trauma remains a leading cause of global morbidity, with tube thoracostomy serving as the definitive intervention for most thoracic injuries. In resource-limited settings, identifying clinical and procedural predictors is essential for optimizing surgical outcomes and reducing preventable morbidity. Objective: This study aimed to evaluate the clinical outcomes of tube thoracostomy and identify independent predictors of prognosis among chest trauma patients at Asella Referral Teaching Hospital. Methods: A hospital-based cross-sectional study was conducted, reviewing the medical records of patients treated with tube thoracostomy for chest injuries between 2020 and 2024. Data were analyzed using SPSS Version 26.0. Initially, the statistical analysis included bivariate screening for variables having p-value < 0.25, followed by multivariable logistic regression to isolate independent variables associated with patient outcomes. Association between variables was taken as statistically significant for the variables resulted in p-value <0.05 on multivariate logistic regression. Results: A total of 171 patients were reviewed, with a strong male predominance (80.7%) and a mean age of 42.93 years (SD=16.27). Blunt trauma was the leading mechanism of injury (81.9%). While the majority of patients (91.2%) achieved a "good" clinical outcome, the overall complication rate was 24%, primarily driven by retained hemothorax (7.9%). Multivariable analysis identified post-procedural complications (AOR = 48.9, 95% CI [5.3-455.6], p=0.001) and tube insertion performed at bedside in Emergency room (AOR=41.7, 95%CI (2.4-718.9), p=0.010), as the two most significant independent predictors of a bad outcome. Conclusion and Recommendation: Although most patients achieved favorable outcomes, prognosis is heavily influenced by the setting of the procedure and the occurrence of preventable complications. Clinical focus must prioritize standardized procedural environments and early, adequate pleural space evacuation to mitigate risks. Keywords: Tube Thoracostomy, Chest Tube, Trauma, Complications, Outcomes, Ethiopia.