Utility of routine chest radiographs in the surgical intensive care unit : a prospective study.
To correlate patient condition and reasons for obtaining chest radiographs (CXRs) with the utility of CXRs in critical illness and to determine the potential impact of stricter criteria for obtaining a CXR in a surgical intensive care unit (ICU).
Inception cohort study of 1003 CXRs examined prospectively.
Patients and Setting
A total of 157 consecutive patients admitted to the general surgical ICU of a 780-bed, urban, university-affiliated, tertiary care hospital.
Nothing was done to influence the ordering of CXRs.
Influence of CXR findings on clinical management.
The likelihood of a clinically important finding was 17% for CXRs obtained for no clear clinical indication (routine), 26% for those obtained to verify the position of a medical device, and 30% for those obtained for suspected clinical conditions.
By univariate analysis, suspected pathophysiologic condition, admission APACHE II (Acute Physiology and Chronic Health Evaluation II) score, presence of a central venous or Swan-Ganz catheter, and length of ICU stay were all predic-tors of a significant finding.
Chest radiographs should only be obtained on surgical ICU patients for specific indications.
Routine CXRs for ICU patients are justified only for patients with indwelling Swan-Ganz catheters.
Mots-clés Pascal : Radiographie, Thorax, Soin intensif, Chirurgie, Etude cohorte, Diagnostic, Homme, Radiodiagnostic
Mots-clés Pascal anglais : Radiography, Thorax, Intensive care, Surgery, Cohort study, Diagnosis, Human, Radiodiagnosis
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0418684
Code Inist : 002B24A02. Création : 01/03/1996.