The Low Value of Daily Chest X-Rays in ICU Patients
Author Information
Author(s): Marleen E Graat, Goda Choi, Esther K Wolthuis, Johanna C Korevaar, Peter E Spronk, Jaap Stoker, Margreeth B Vroom, Marcus J Schultz
Primary Institution: Academic Medical Center, University of Amsterdam
Hypothesis
The study aims to evaluate the frequency of unexpected major abnormalities identified by daily routine chest radiographs and their impact on patient care in the ICU.
Conclusion
Daily routine chest radiographs in the ICU rarely reveal unexpected, clinically relevant abnormalities and seldom lead to changes in patient management.
Supporting Evidence
- Only 5.8% of daily routine CXRs revealed unexpected abnormalities.
- In only 2.2% of daily routine CXRs did these abnormalities result in a change to therapy.
- The majority of daily routine CXRs did not reveal any new predefined major finding.
Takeaway
Doctors in the ICU take daily X-rays of patients, but most of the time, these X-rays don't show anything new or important that changes how they treat the patients.
Methodology
This was a prospective observational study conducted in a 28-bed mixed medical-surgical ICU over five months, analyzing daily routine chest radiographs.
Potential Biases
Radiologists were not blinded to the expectations of the clinical staff, which could introduce bias in interpreting the CXRs.
Limitations
The study design allowed for potential bias in categorizing CXRs, and the clinical relevance of some abnormalities was not evaluated.
Participant Demographics
{"total_patients":754,"age_mean":59.8,"male_percentage":63.0,"length_of_stay_median":2.5,"mortality_percentage":9.5}
Statistical Information
P-Value
p<0.05
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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