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Routine chest radiograph is not indicated after open tracheostomy: a multicenter perspective
Alan H Tyroch1, Krista Kaups, Manuel Lorenzo
1Department of Surgery, Texas Tech University Health Sciences Center, El Paso 79905-2700, USA.
The American Surgeon
|December 7, 2002
Summary
Routine chest X-rays (CXRs) after uncomplicated open tracheostomy in adults are unnecessary and not cost-effective. This study found no significant findings in patients without clinical indications, questioning the standard practice.
Area of Science:
- Thoracic Surgery
- Diagnostic Imaging
- Critical Care Medicine
Background:
- Postoperative chest radiography (CXR) is a common practice following open tracheostomy.
- The necessity and cost-effectiveness of routine CXRs in uncomplicated cases are debated.
Purpose of the Study:
- To evaluate the utility of routine chest radiographs (CXRs) after uncomplicated open tracheostomy in adult patients.
- To determine if immediate postoperative CXRs are necessary when no clinical indications are present.
Main Methods:
- A prospective, multicenter study involving adult surgical patients undergoing open tracheostomy.
- CXRs were obtained only for specific clinical indications, not routinely in the immediate postoperative period.
- Preoperative and subsequent postoperative CXRs were reviewed for complications.
Main Results:
- 151 tracheostomies were performed across four institutions by 22 surgeons.
- In patients without clinical indications (n=147), subsequent CXRs showed no significant new findings.
- In four patients with potential complications, posttracheostomy CXRs were not diagnostic.
Conclusions:
- Routine chest radiography is not indicated after uncomplicated open tracheostomy in adults.
- Eliminating routine CXRs can contribute to cost containment in healthcare.
- Clinical judgment should guide the decision for obtaining a postoperative CXR.