Frequency and Risk Factors of Bronchopleural Fistula in Tube Thoracostomy Patients

Abstract

Objective:           To           determine the frequency of Bronchopleural Fistula (BPF) in patients underwent tube thoracostomy (TT), and associated risk factors in BPF.

Methods:             A descriptive observational research was conducted at Chest Units of Ojha Institute of Chest Diseases, Dow University of Health Sciences (DUHS) Karachi from September 2018 to February 2019 on 125 patients selected by consecutive sampling method. Patients underwent for tube thoracostomy were included in the study, whereas children (age < 13 years), pregnant women or patients diagnosed with multiloculated empyema or multiloculated pleural effusion were excluded from the study. BPF was diagnosed based on continuous air leak for > 72 hours.

Results:  Out of 125 patients underwent for TT, BPF was detected in 38 (30.4%) patients. Out of which 28 (73.7%) patients were male, and 10 (26.3%) were female. BPF was classiied into continuous 17 (44.7%), expiratory 13 (34.2%), force expiratory 4 (10.4%) and inspiratory 4 (10.4%) patients. The odds of BPF was 4.65 times higher among individuals with diabetes mellitus (AOR: 4.65, 95% CI: 1.14-18.95), 2.17 times higher among individuals with COPD (AOR: 2.17, 95% CI: 0.45-10.42), 2.80 times higher among individuals with TB (AOR: 2.80, 95% CI: 1.09-7.22), 2.74 times higher among individuals with empyema (AOR: 2.74, 95% CI: 0.96-7.83), 2.49 times higher among individuals with smoking (AOR: 2.49, 95% CI: 0.95-6.49), while individuals with malignancy were 90% less likely to have BPF (AOR: 0.10, 95% CI: 0.01-0.99).

Conclusion:     The research concludes that prevalence of bronchopleural istula is high among tube thoracostomy patients, and risk factors such as DM, COPD, TB, and non-malignant are signiicantly associated withn BPF.