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  1. Utility of routine chest radiographs in the surgical intensive care unit : a prospective study.

    Article - En anglais

    Objectives 

    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).

    Design 

    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.

    Intervention 

    Nothing was done to influence the ordering of CXRs.

    Outcome Measures 

    Influence of CXR findings on clinical management.

    Results 

    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.

    Conclusions 

    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

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 95-0418684

    Code Inist : 002B24A02. Création : 01/03/1996.