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Related Experiment Videos

Pre-operative chest x-rays in elderly patients.

K Törnebrandt, R Fletcher

    Anaesthesia
    |September 1, 1982
    PubMed
    Summary

    Routine pre-operative chest X-rays are valuable for elderly surgical patients. Despite appearing to lack indications, many older adults show abnormalities on chest X-rays, preventing surgical delays.

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    Area of Science:

    • Geriatric Medicine
    • Radiology
    • Surgical Pre-assessment

    Background:

    • Pre-operative chest X-rays (CXR) are standard for surgical patients.
    • The necessity of routine CXR in elderly patients (70+ years) is debated.
    • Cost-effectiveness and clinical utility of routine CXR in this demographic require evaluation.

    Purpose of the Study:

    • To assess the diagnostic yield of routine pre-operative chest X-rays in elderly patients undergoing elective surgery.
    • To determine the proportion of elderly patients without a clear medical indication for CXR who have abnormal findings.
    • To evaluate the clinical and economic implications of discontinuing routine pre-operative CXR in this population.

    Main Methods:

    • Prospective study of 100 consecutive patients aged 70 years or more undergoing elective surgery.
    • Assessment of medical indication for pre-operative chest X-ray.
    • Review of chest X-ray findings for all included patients.

    Main Results:

    • Out of 100 elderly patients, only 27 were initially deemed to lack a medical indication for chest X-ray.
    • Of these 27 patients, 10 (37%) demonstrated abnormal findings on their chest X-ray.
    • These unexpected findings suggest a significant underestimation of clinical relevance in this age group.

    Conclusions:

    • Routine pre-operative chest X-rays are highly beneficial in patients aged 70 and above.
    • Abandoning this practice could lead to significant financial losses due to surgical delays and missed diagnoses.
    • The information gained from pre-operative CXR outweighs potential cost savings from its discontinuation in the elderly.

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