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Am J Surg ; 214(1): 19-23, 2017 Jul.
Article in English | MEDLINE | ID: mdl-27769542

ABSTRACT

INTRODUCTION: A daily Chest X-ray (CXR) is obtained in many surgical intensive care units (SICU). This study implemented a selective CXR protocol in a high volume, academic SICU and evaluated its impact on clinical outcomes. METHODS: All SICU patients admitted in 2/2010 were compared with patients admitted in 2/2012. Between the time periods, a protocol eliminating the routine daily CXRs was instituted. RESULTS: In 02/2010 and 02/2012, 107 and 90 patients were admitted to the SICU, respectively, for a total of 1384 patient days. CXRs decreased from 365 (57.1% of patient-days) in 2010 to 299 (40.9% of patient days; p < 0.001) in 2012. A greater proportion of Physician Directed CXRs (PDCXRs) had new findings (80.8%) compared to Automatic Daily CXRs (ADCXRs) (23.5%, p < 0.001). There was no difference in overall or SICU length of stay, ventilator-free days, morbidity or mortality. CONCLUSION: Eliminating ADCXRs decreased the number of CXRs performed, without affecting LOS, mechanical ventilation, morbidity or mortality. Physician-directed ordering of CXRs increased the diagnostic value of the CXR and decreased the number of clinically irrelevant CXRs performed.


Subject(s)
Clinical Protocols , Critical Care/methods , Intensive Care Units , Radiography, Thoracic/statistics & numerical data , Adolescent , Adult , Aged , Female , Hospital Mortality , Humans , Length of Stay , Los Angeles , Male , Middle Aged , Prospective Studies , Respiration, Artificial , Unnecessary Procedures , Young Adult
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