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Evaluation of the Clinical Utility of Routine Daily Chest Radiography in Intensive Care Unit Patients With Tracheostomy Tubes: A Retrospective Review
Journal article   Peer reviewed

Evaluation of the Clinical Utility of Routine Daily Chest Radiography in Intensive Care Unit Patients With Tracheostomy Tubes: A Retrospective Review

Jeffrey Cruz, Michael Ferra, Aditya Kasarabada, James Gasperino and Beth Zigmund
Journal of intensive care medicine, v 31(5), pp 333-337
Jun 2016
DOI: https://doi.org/10.1177/0885066614538393
PMID: 24916754
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Cost-Benefit Analysis Critical Care - economics Critical Illness - economics Critical Illness - therapy Humans Intensive Care Units - economics Postoperative Care Radiation Exposure Radiography, Thoracic - adverse effects Radiography, Thoracic - economics Radiography, Thoracic - utilization Retrospective Studies Tracheostomy Unnecessary Procedures - economics
The utilization of imaging procedures is under scrutiny due to high costs and radiation exposure to patients and staff associated with some radiologic procedures. Within our institution's intensive care unit (ICU), it is common for patients to undergo chest radiography (CR) not only immediately following tracheostomy tube placement but also on a daily basis, irrespective of the patient's clinical status. We hypothesize that the clinical utility of performing routine daily CR on patients with tracheostomy tubes is low and leads to unnecessary financial cost. A retrospective medical chart review was done on 761 CRs performed on 79 ICU patients with tracheostomy from April 2010 to July 2011. We searched the radiology reports of the 761 CRs for the presence of new radiographically detected complications and reviewed medical records to determine which complications were clinically suspected and which radiology reports led to changes in patient management. Of the 761 CRs, only 18 (2.3%) radiographs revealed new complications. All complications were clinically suspected prior to imaging. Only 5 (0.7%) complications resulted in a management change. The most common management changes were a change in antibiotic regimen (0.3%) and ordering of diuretics (0.3%). Routine daily imaging of patients with tracheostomy in an ICU provides little clinical utility, and CR in this population should be performed selectively based on the patient's clinical status.

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3 Record Views
10 citations in Web of Science
10 citations in Scopus

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UN Sustainable Development Goals (SDGs)

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#3 Good Health and Well-Being

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Web of Science research areas
Critical Care Medicine
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