Preoperative chest x-ray films in elective surgery: a valid screening tool

Area of Science:

• Medical Imaging
• Thoracic Surgery
• Diagnostic Radiology

Background:

• Preoperative chest X-rays are commonly used to assess surgical patients.
• The yield of routine preoperative chest X-rays in elective surgery is debated.
• Identifying patients who benefit most from preoperative imaging is crucial for resource optimization.

Purpose of the Study:

• To evaluate the incidence and clinical significance of abnormal preoperative chest X-ray findings in patients undergoing elective surgery.
• To determine the correlation between abnormal X-ray findings and patient demographics, medical history, and clinical outcomes.
• To inform guidelines for the selective ordering of preoperative chest X-rays.

Main Methods:

• Retrospective review of 1000 patients undergoing elective surgery.
• Analysis of preoperative chest X-ray films for abnormalities.
• Correlation of X-ray findings with patient age, sex, medical history, symptoms, and clinical outcomes.

Main Results:

• Overall abnormal preoperative chest X-ray rate was 7.4% (5.8% women, 10.5% men).
• Abnormalities were significantly more frequent in patients over 50 (30%) versus younger patients (3%).
• 92% of patients with abnormal X-rays had a history or symptoms of cardiorespiratory disease; no adverse outcomes were linked to asymptomatic, radiographically abnormal findings.

Conclusions:

• Routine preoperative chest X-rays may not be necessary for all elective surgery patients.
• Selective ordering based on age and cardiorespiratory risk factors could improve efficiency.
• Further guidelines are recommended to optimize the use of preoperative chest imaging.