Journal of Multidisciplinary Healthcare (Dec 2023)

Determinants of Pneumothorax Among Mechanically Ventilated COVID-19 Intensive Care Unit Patients, a Single Centre Study

  • Hundie TG,
  • Alemu ZA,
  • Getachew LZ,
  • Abera LA,
  • Seyoum AB,
  • Mogus LS,
  • Admasu NM,
  • Regassa GB,
  • Tilahun YB,
  • Bareamichael PI,
  • Tessema AG,
  • Derese TN

Journal volume & issue
Vol. Volume 16
pp. 3977 – 3989

Abstract

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Tsegaye Gebreyes Hundie,1,2,* Zewdie Aderaw Alemu,3 Lidiya Zenebe Getachew,4 Lidya Abebe Abera,4 Abebaw Bekele Seyoum,1 Lia Solomon Mogus,3 Nardos Mulu Admasu,5 Gadise Bekele Regassa,6 Yohannes Bayou Tilahun,7 Pineal Iyassu Bareamichael,8 Abel Girma Tessema,9 Tadios Niguss Derese1,* 1Department of Research and Training, Eka Kotebe General Hospital, Addis Ababa, Ethiopia; 2Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 3Department of Public Health, Gamby Medical and Business College, Addis Ababa, Ethiopia; 4Department of Internal Medicine, Eka Kotebe General Hospital, Addis Ababa, Ethiopia; 5Department of Pediatric Surgery, Addis Ababa University, Addis Ababa, Ethiopia; 6Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia; 7General Practitioner at HealthHub Specialty Clinics by Al-Futtaim, Dubai, United Arab Emirates; 8Department of Internal Medicine, Addis Ababa University, Addis Ababa, Ethiopia; 9Department of Immunology, University of Manchester, Manchester, UK*These authors contributed equally to this workCorrespondence: Tsegaye Gebreyes Hundie, Email [email protected]: Millions of deaths and co-morbidities have been brought on by the COVID-19 epidemic worldwide. Acute respiratory distress syndrome (ARDS), multiple organ failure, and death can result from the condition in some people. The disease’s course can range from a moderate upper respiratory tract infection to severe pneumonia. Numerous reports have been made on the occurrence of pneumothorax in COVID-19 ICU patients, particularly in those who are receiving invasive ventilation. This study assesses factors associated with pneumothorax among mechanically ventilated COVID-19 ICU patients in Addis Ababa, Ethiopia.Methods: A case-control study design was employed from August 1, 2022, to August 31, 2022, GC, with a sample size of 281, where cases are 94 and controls are 187. A pre-tested structured quantitative tool was used to collect data on ODK and export it to SPSS version 26 for analysis. Descriptive statistics were presented using text and tables. The association between variables was analyzed with binary logistic regression. A statistical significance was declared at a p-value of 0.05 with a 95% confidence interval. Assumptions like model fitness and multicollinearity were checked to be satisfied.Results: A total of 281 (94 cases and 187 controls) patient charts were carefully reviewed. After adjustment for possible confounders in multivariate analysis, ARDS (AOR = 0.214, 95% CI (0.088, 0.519), P value =0.001) and invasive ventilation (AOR = 0.311, 95% CI (0.121, 0.796), P value =0.015) had a significant association with pneumothorax.Conclusion: Despite the introduction of preventive breathing methods, pneumothorax is still a frequent and deadly consequence in COVID-19 patients with ARDS. ARDS and invasive mechanical ventilation were found to be significantly associated with the development of pneumothorax. Health facilities should be well equipped with recent medical equipment in intensive care units and with well-trained and organized manpower.Keywords: pneumothorax, mechanical ventilation, intensive care unit, Eka Kotebe General Hospital, COVID-19

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