Postoperative portable chest radiographs: optimum use in thoracic surgery

The Journal of Thoracic and Cardiovascular Surgery
R J GrahamN A Obuchowski

Abstract

Daily portable chest radiographs are routinely ordered in many institutions after thoracic surgery. Our purpose was to assess the efficacy and cost of this practice and to determine the optimum use of postoperative x-ray studies. A prospective review of all portable chest x-ray films after 100 consecutive elective thoracotomies (DRG 75) was conducted. Each x-ray study initiated a three-part survey. First, the surgeon listed whether the x-ray study was routine and the anticipated management had it not been available. The radiologist then interpreted and scored the x-ray study as follows: negative, expected findings; A, minor findings necessitating no intervention; B, minor findings necessitating intervention; or C, major findings necessitating intervention. Finally, the x-ray film and the interpretation were returned to the surgeon. Any interventions necessitated by the x-ray study were recorded. In 6 months, 99 patients underwent 82 pulmonary resections and 18 other major procedures. In the postoperative period, 769 portable chest x-ray studies were ordered, median five per patient (range 2 to 49). Of these, 731 (95%) were routine and 38 (5%), nonroutine. Severity scores were as follows: negative in 106 (13.8%), A in 558 (72.5%...Continue Reading

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Citations

Jan 6, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Eric GoudieMoishe Liberman
Apr 11, 2013·Journal of the American College of Radiology : JACR·Judith K AmorosaRakesh D Shah
May 5, 2009·The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland·M R WhitehouseJ A Morgan
Feb 5, 2008·The Journal of Thoracic and Cardiovascular Surgery·Utz KappertKlaus Matschke
Aug 21, 2013·Interactive Cardiovascular and Thoracic Surgery·Jeremie ReebGilbert Massard
Nov 12, 2014·Journal of Cardiothoracic Surgery·Martijn TolsmaNardo van der Meer
Aug 3, 2020·The Annals of Thoracic Surgery·Eleah D PorterJoseph D Phillips
Nov 14, 2020·The Annals of Thoracic Surgery·Marek MalíkMarián Grendár

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