The efficacy of x-rays after chest tube removal

• Published in: The American journal of surgery 2000-01, Vol.179 (1), p.13-15
• Main Authors: Palesty, J.Alexander, McKelvey, Alicia A, Dudrick, Stanley J
• Format: Article
• Language: English
• Subjects: Background radiation; Chest; Chest Tubes; Complications; Cost Control; Costs and Cost Analysis; Demographics; Female; Hippocrates (460?-377? BC); Humans; Male; Medical records; Middle Aged; Patients; Pneumothorax; Radiographs; Radiography; Radiography, Thoracic - economics; Radiography, Thoracic - statistics & numerical data; Retrospective Studies; Suctioning; Surgeons; Thoracostomy; Trauma; Trauma Centers; Tubes; X-rays
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/S0002-9610(99)00260-3

Background: The insertion and subsequent removal of chest tubes are frequently performed procedures. We hypothesize that routine chest radiographs obtained after chest tube removal to confirm the absence of any post-procedure complications have little impact on clinical management. Materials and methods: A 5-year retrospective study of 73 patients with tube thoracostomies was performed in a level II trauma center’s intensive care unit. Patients were identified from billing records for chest tube placement. Medical records and official chest x-ray film reports, both before and after removal, were reviewed, and demographic data were collected. Results: Of the 73 patients examined, only 8 had postprocedure reports that differed from the preprocedure reports. Two of these 8 patients required reinsertion of a chest tube to treat the recurrence of a significant pneumothorax. However, the decision to reinsert the chest tube was based on the patient’s clinical appearance rather than on the x-ray findings. Conclusion: Chest radiography following the removal of chest tubes should not be a routinely performed procedure, but should preferably be based on the good clinical judgement and discrimination of the surgeon.