Routine pre-operative chest radiographs in non-cardiopulmonary surgery

The routine pre-operative chest radiographs of 203 consecutive patients scheduled for elective non-cardiopulmonary surgery were reviewed. There were 122 abnormal findings, 27 (22%) of which were significant, 95 (77.8%) insignificant. Of the former, 74% were due to cardiomegaly, while the latter included such findings as aortic unfolding (87%), pleural thickening (5.26%) and cervical ribs (2.11%). No abnormalities were found in subjects below 30 years of age, and there were no significant abnormal findings in subjects aged less than 40 years. This study shows that routine pre-operative chest radiographs in patients undergoing elective noncardiopulmonary surgery should be limited to patients with clinical symptoms, and high-risk patients, especially individuals aged greater than or equal to 50 years. Such radiographs are unnecessary in asymptomatic patients less than or equal to 30 years of age.