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[Protocol for preoperative chest X-rays in elective surgery].

S Vesconi1, R Riedo, G Ciceri

  • 1Azienda Ospedaliera Ospedale Civile di Vimercate, Desio.

Minerva Anestesiologica
|March 29, 2000
PubMed
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This study shows that a protocol can safely reduce routine preoperative chest X-rays (CXRs) for elective surgery patients, decreasing radiation exposure and costs without adverse effects.

Area of Science:

  • Anesthesiology
  • Radiology
  • Health Economics

Background:

  • Preoperative chest X-rays (CXRs) are commonly used in evaluating patients for elective surgery.
  • Optimizing the use of preoperative CXRs can reduce unnecessary radiation exposure and healthcare costs.

Purpose of the Study:

  • To evaluate the effectiveness of a protocol designed to optimize the use of preoperative chest X-rays (CXRs).
  • To assess the impact of this protocol on patient safety, radiation exposure, and costs in elective surgery.

Main Methods:

  • An observational prospective study was conducted in a 350-bed general hospital.
  • A protocol was implemented to guide the avoidance of routine CXRs in selected patients undergoing elective surgery.
  • Patient selection criteria included age, smoking status, respiratory/cardiovascular symptoms, neoplastic disease, type of surgery, immunosuppressive therapy, and TB endemic area status.

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Main Results:

  • 3795 out of 5198 patients were enrolled; 3456 underwent surgery without CXRs.
  • No critical events or major perioperative complications were observed in patients who did not have preoperative CXRs.
  • Preoperative CXRs, performed in 152 cases, yielded useful information impacting clinical management in 20 instances.

Conclusions:

  • The protocol effectively reduced the number of routine preoperative CXRs for elective surgery patients.
  • This reduction led to significant decreases in radiation exposure and healthcare costs.
  • The protocol demonstrated safety without evident negative side-effects, supporting its implementation in clinical practice.