Clinical Profile and Outcomes of Thoracic Trauma Managed with Tube Thoracostomy: A Five-Year Retrospective Cohort Study at a Tertiary Care Hospital in Punjab, Pakistan

Vollständiger Abstract

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Background: Thoracic trauma is a leading cause of injury-related morbidity and mortality worldwide, disproportionately affecting young, economically active adults, particularly in low- and middle-income settings. Tube thoracostomy remains the cornerstone of its emergency management, yet locoregional data describing the clinical profile and outcomes of thoracic trauma managed this way remain scarce in Pakistan. This study describes the clinical profile, management, and short-term procedural outcomes of thoracic trauma patients requiring tube thoracostomy at a tertiary care hospital.Methodology: This retrospective cohort study included 700 patients with blunt or penetrating thoracic trauma who underwent tube thoracostomy at the Department of Thoracic Surgery, Services Hospital, Lahore, over five years (January 2019-December 2024). Data on demographics, department performing the procedure, documented mechanism of injury, and procedure-related complications were extracted from hospital records using pre-specified operational definitions. Continuous variables were summarized as mean ± standard deviation and categorical variables as frequencies and percentages, using SPSS version 26.Results: Of 700 patients, 526 (75.1%) were male and 174 (24.9%) female; 480 (68.5%) were aged 12-50 years. The Thoracic Surgery Department performed 457 of 700 procedures (65.3%); 144 (20.6%) patients were referred after tube placement else-where. A documented traumatic mechanism was recorded in 352 of 700 patients (50.3%), most commonly hemopneumothorax (141/352, 40.1%) and pneumothorax (94/352, 26.7%). Technical complications occurred in 244 of 700 procedures (34.9%), pre-dominantly lung parenchymal malposition (163/244, 66.8%); process-related complications occurred in 323 of 700 (46.1%), most often ineffective placement requiring re-intervention (113/323, 35.0%).Conclusion: Thoracic trauma managed with tube thoracostomy in this cohort predominantly affected young males and was associated with a substantial procedure-related complication rate, most often related to tube malposition and ineffective placement.