胸部X射线在心胸重症监护室过度使用 根据美国放射学学院的标准
Sandeep N Bharadwaj1, Ben Smith2, Dominic Vitello3
1Division of Cardiac Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Annals of thoracic surgery short reports
|January 10, 2025
概括
常规的胸部X射线 (CXR) 在心胸重症监护室 (ICU) 过度使用. 大多数CXR不符合适当性标准,并产生较少的可操作发现,这表明改善资源使用是可能的.
科学领域:
- 放射学 放射学是一门学科.
- 胸部外科手术 胸部外科手术
- 关键护理医学 关键护理医学
背景情况:
- 常规的胸部X射线图 (CXR) 在术后护理途径中很常见.
- 之前的研究集中在特定的CXR指示上,但心胸外科手术的整体管理没有得到很好的描述.
- 本研究描述了CXR利用及其对心胸重症监护室 (ICU) 患者管理的影响.
研究的目的:
- 在心胸重症监护室 (ICU) 描述胸部放射图 (CXR) 的使用情况.
- 量化满足已确定的适当性标准的CXR的比例.
- 评估CXR使用对患者管理和资源利用的影响.
主要方法:
- 在心胸科ICU中3个月内对所有CXR进行的回顾性审查.
- 根据美国放射学学院 (ACR) 适当性标准对CXR进行指示或非指示的分类.
- 评估CXR报告和临床病史,以确定可行的或意想不到的发现.
主要成果:
- 进行了1273次CXR;55.9%用于日常日常监测.
- 只有34.3%的CXR符合ACR适当性标准,而65.7%不符合标准 (P = .002).
- 与指定的CXR相比,不符合标准的CXR的可操作发现显著减少 (3.8%),比指定的CXR (13.0%,P = .02).
结论:
- 胸部X射线 (CXR) 的过度使用在心胸科ICU中很普遍,超过了美国放射学学院 (ACR) 的指导方针.
- 在ACR指南之外执行的CXR产生了较少的可操作发现.
- 优化CXR使用可以提高心胸外科手术患者的资源利用率和护理效率.
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