Hamzah, Ahmad
(2008)
The value of routine portable
chest radiograph of patients in
intensive care unit (ICU).
Masters thesis, Universiti Sains Malaysia.
Abstract
The value of routine portable chest radiograph of patients in Intensive Care Unit (ICU).
Introduction:
Since the advent of ICU set up, there has been two schools of thought regarding the usage of
routine portable chest radiograph in critically ill patients. One school of thought says that
routine portable CXR will give a significant nwnber of unsuspected findings while the other
claimed that it just increased radiation dose to the patient and little benefits obtained. At
present, two standards of care have evolved, one using routine CXR and the other using
clinically indicated CXR.. In Hospital Universiti Sains Malaysia (HUSM), some of our ICU
physicians practised routine CXR particularly in cardiopulmonary disease with some
modification while some of them requested CXR when clinically indicated. Our study aim is
to detennine the diagnostic and therapeutic efficacy of routine chest radiographs in ICU
HUSM
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Methodology:
This study was a cross sectional design conducted in HUSM starting from October 2006 till
March 2007. 1016 CXRs were obtained within the study period and 501 portable CXRs were
included in this study. The CXR were analysed and divided into routine and non routine
groups. The CXR findings were recorded. The images were reviewed by a trainee radiologist
using GE Pathspeed Diagnostic Workstation in the department of radiology. Approval from
the Research Board Committee was obtained prior to study.
Results:
Fifty five (17.3 %) CXR.s showed new lesions or significant abnonnality in routine group,
compared with 132 (72.1 %). There was a significant difference of detecting new lesion
between routine and non routine with p value of 0.001. The CXR with new findings that
resulted in an intervention was significantly higher in non routine compared to the routine
groups, 68.9% and 9.4% respectively with p value ofO.OOl.
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Conclusion:
The non routine protocol yielded better diagnostic and therapeutic efficacy than routine
CXR. The use of routine CXR is not cost effective. It resulted in an increased radiation dose
to the patient with only little benefits.
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