Evaluation of routine postoperative chest X-rays in the management of the cardiac surgical patient [published erratum appears in Eur J Cardiothporac Surg 1998 Feb;13(2):218]

• Published in: European journal of cardio-thoracic surgery 1997-11, Vol.12 (5), p.724-729
• Main Authors: PODILA SITA RAMA RAO, ABID, Q, KHAN, K. J, MEIKLE, R. J. R, NATARAJAN, K. M, MORRITT, G. N, WALLIS, J, KENDALL, S. W. H
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Cardiac Surgical Procedures; Diagnostic Tests, Routine; Female; Humans; Male; Medical sciences; Middle Aged; Postoperative Care; Radiography, Thoracic; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/S1010-7940(97)00132-2

OBJECTIVES: To evaluate the role of routine chest X-rays in the management of patients post cardiac surgery. METHODS: 340 adult patients undergoing cardiac surgery were studied in three consecutive groups (A, B,C) of 100 patients each. Forty patients were excluded due to the intensivecare stay greater than 36 h (n = 35), or early mortality within 36 h (n =5). Routine chest X-rays were performed according to different protocols in Groups A and B. In group C there were no routine chest X-rays during the entire postoperative period [corrected]. In all three groups chest X-rays were performed where clinically indicated. Group A had three routine chest X-rays post-operation. Group B had one routine chest X-ray on day 4 post-operation. Group C had chest X-rays only when indicated. The X-rays were evaluated in terms of their assistance value and the resultant numberof interventions. RESULTS: The three groups were similar preoperatively forage, sex, preoperative left ventricular function, presence of chronic obstructive airway disease and type of operation performed. The totalnumber of chest X-rays in groups A, B and C were 304, 133 and 36, respectively. The number of chest X-rays leading to interventions were five, four and four in groups A, B and C, respectively. Chest X-rays that helped in management were 36, 28, and 28, respectively, in the same groups. There was no mortality or morbidity attributable to non-performance of routine chest X-ray. CONCLUSIONS: Routine chest X-rays post-cardiac surgery are of very little value and patients are adequately managed by performing chest X-rays only when clinically indicated. There was no increased mortality or morbidity attributed to lack of routine chest X-rays in any of these groups. We recommend performing chest X-rays only when clinically indicated in satisfactorily recovering adult cardiac surgical patients.