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Utilidad de los roentgenogramas de detección de tórax en pacientes preoperatorios
JAMA
|December 16, 1983
Resumen
Los criterios clínicos pueden identificar a los pacientes quirúrgicos que es poco probable que necesiten radiografías torácicas preoperatorias anormales. Un estudio encontró que solo el 0,3% de los pacientes sin factores de riesgo tenían roentgenogramas torácicos anormales, lo que sugiere que la detección selectiva es efectiva.
Área de la Ciencia:
- Imágenes médicas de imágenes médicas.
- Cirugía torácica cirugía torácica.
- Diagnóstico Clínico El diagnóstico clínico.
Sus antecedentes:
- Los roentgenogramas torácicos preoperatorios son comunes en las admisiones quirúrgicas.
- La identificación de pacientes que no requieren radiografías de tórax puede optimizar la asignación de recursos.
- Los factores clínicos pueden predecir la probabilidad de hallazgos anormales en el roentgenograma de tórax.
Objetivo del estudio:
- Para determinar si los criterios clínicos pueden identificar a los pacientes quirúrgicos con una probabilidad muy baja de anormalidad en el tórax preoperatorio. roentgenogramas.
- Evaluar la utilidad del cribado selectivo de rayos X de tórax en las admisiones quirúrgicas.
Principales métodos:
- Cribado de 905 hospitalizaciones quirúrgicas en busca de factores de riesgo clínico asociados con roentgenogramas torácicos anormales.
- Categoría de los pacientes en grupos con y sin factores de riesgo identificables.
- Análisis de los hallazgos de la roentgenografía torácica preoperatoria en cada grupo.
Principales resultados:
- De 368 pacientes sin factores de riesgo, solo uno (0,3%) tenía un roentgenograma torácico anormal que no afectó la cirugía.
- No se encontraron anormalidades significativas en los pacientes restantes sin factores de riesgo.
- Entre 504 pacientes con factores de riesgo identificables, 114 (22%) tenían anormalidades graves en las radiografías torácicas preoperatorias.
Conclusiones:
- Los criterios clínicos pueden identificar efectivamente un subgrupo de pacientes quirúrgicos que es poco probable que tengan anomalías en los roentgenogramas torácicos preoperatorios.
- La detección selectiva basada en factores clínicos puede reducir las radiografías torácicas preoperatorias innecesarias.
- Este enfoque puede potencialmente mejorar la eficiencia en la evaluación preoperatoria del paciente.
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