Annual Meeting of The American Association for Thoracic Surgery. Washington, DC, USA, 1997/05/04.
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%),
B in 59 (7.7%), and C in 46 (6.0%). X-ray findings altered management in 43 of 769 studies (5.6%) : in 33 routine (4.5%), in 10 nonroutine (26.3%), in 13 A (2.3%), in 22 B (37.3%), and in 8 C (17.4%). (...)
Mots-clés Pascal : Chirurgie, Thorax, Radiographie, Portatif, Postopératoire, Coût, Economie santé, Analyse coût efficacité, Exploration, Homme, Radiodiagnostic
Mots-clés Pascal anglais : Surgery, Thorax, Radiography, Portable, Postoperative, Costs, Health economy, Cost efficiency analysis, Exploration, Human, Radiodiagnosis
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0110448
Code Inist : 002B24A02. Création : 22/06/1998.