title: Indications and morbidity of tube thoracostomy performed for traumatic and non-traumatic free pleural effusions in a low-income setting.
abstract: BACKGROUND
  Tube thoracostomy (TT) is widely used to resolve a number of pleural conditions. Few data are available on the complications of TT performed for non-traumatic conditions, especially in low income setting. The aim of this study is to analyse the indications and complications of TT performed for both traumatic and non-traumatic conditions of the chest in a low-income environment.
  
  
  METHODS
  This retrospective study conducted over a four years period in a the Regional Hospital, Limbe in South-West Cameroon analyses the rate and nature of complications after TT performed for both traumatic and non-traumatic conditions. Different factors related to complications are analysed.
  
  
  RESULTS
  We analysed 134 patients who had 186 chest tubes inserted. After placement, tubes were either connected to a water seal system (40%) or submitted to suction (60%). Most (91%) procedures were performed for a non-traumatic condition. Non-infectious pleural effusion in patients with HIV infection or pulmonary tuberculosis was the most common indication. Sixty six per-cents of procedures were carried out by a general surgeon. The complication rate was 19.35%. The most common complications included tube dislocation and pneumothorax. Most complications were solved by replacement of the tube. The nature of operator (general surgeon vs general practitioner) was a significant predictor of outcome (p < 0.01). No procedure related death was recorded.
  
  
  CONCLUSIONS
  TT is a safe and efficient procedure to drain pleural collections of both traumatic and non-traumatic origins, even in low-income settings. The incidence of complications could be reduced by a better training of general practitioners on this procedure.
authors.affiliation: Regional Hospital Limbé and Faculty of Health Sciences, University of Buea, Yaoundé, Cameroon.
authors.forename: Alain Chichom
authors.initials: AC
authors.lastname: Mefire
authors.affiliation: General and Reference Hospital, Yaoundé, Cameroon.
authors.forename: Marcus
authors.initials: M
authors.lastname: Fokou
authors.affiliation: Regional Hospital Limbé, Limbé, Cameroon.
authors.forename: Louis Din
authors.initials: LD
authors.lastname: Dika
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002163:Cameroon; D015505:Chest Tubes; D002648:Child; D002675:Child, Preschool; D004322:Drainage / Q000379:methods*; D005260:Female; D015658:HIV Infections / Q000150:complications; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D011203:Poverty; D012189:Retrospective Studies; D013907:Thoracostomy / Q000009:adverse effects / Q000379:methods*; D014397:Tuberculosis, Pulmonary / Q000150:complications; D055815:Young Adult
keywords: Tube thoracostomy; complications; indications; non-traumatic; pleural effusion; traumatic