Characterization of patients undergoing closed thoracostomy in a high-complexity institution in Manizales, Colombia (2015-2020)

Caracterización de los pacientes llevados a toracostomía cerrada en una institución de alta complejidad en Manizales, Colombia (2015-2020)

This article displays the results of a historical and one-center review focused on the demographic, clinic, and therapeutic items of 480 patients older than 18 who were treated for chest trauma throughout 5 years. Objectives: to characterize the population older than 18 who required the insertion of a chest tube as part of the treatment of traumatic chest diseases. Methods: an observational and descriptive study was made by means of the review of clinic histories, with the previous approval of the Local Ethics Committee (SES Hospital de Caldas), a search in the digital file of clinic histories was realized over a period of six years, from January 1st, 2015, to December 31st, 2020. The initial database was produced using the codes of classification CIE-10 (International Classification of Diseases 10th revision), and inclusion and exclusion criteria were applied. The final database was refined with the program EpiInfo® (CDC, Center for Disease Control and Prevention) and finally processed with the statistical program SPSS® version 25 (IBM, year 2022). Results: we found the mean age of the population was 29.7 years, with a predominance of male gender (95%), the most common trauma mechanism was stabbing (81.25%), the vital sign more often altered was SO2 (89%), the more often altered variable was shock index (0.9), and the medications most prescribed were: subcutaneous lidocaine in the perioperative period (71.46%) and metamizole in the post-operative period (50.8%). After the bivariate analysis, the association between male gender and the need for a closed thoracostomy was demonstrated (OR 7.3.  IC 1, 3–153, p < 0,05); in the same way, we found a statistical relation between exposition to illicit drugs and the need for a closed thoracostomy (OR 2.1. IC 1. 4–3, p < 0.05). Conclusions: chest trauma is more frequent among male patients who are in the younger stage of adulthood, with previous exposure to illicit drugs. It is usual to administer local anesthetics only in the perioperative period, despite current articles that support and guide the use of painkillers and sedative agents outside the operating room. This is why we recommend that non-anesthesiologist physicians receive constant training about the management of those medications in chest trauma.