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.
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.