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Daily Chest Radiography in ICU May Be Unnecessary

Mortality, length of stay, ventilator days not affected when daily radiographs eliminated

MONDAY, April 26 (HealthDay News) -- Daily routine chest radiography in adults in intensive care units (ICUs) could likely be eliminated without a subsequent increase in adverse outcomes, according to research published in the May issue of Radiology.

Yuji Oba, M.D., and Tareq Zaza, M.D., both of the University of Missouri at Columbia, conducted a meta-analysis of eight clinical trials with a total of 7,078 patients which had evaluated abandonment of daily routine chest radiography in the ICU. They performed a pooled analysis to evaluate length of ICU and hospital stay, ICU and hospital mortality, and days on a ventilator.

The researchers found that neither hospital (odds ratio [OR], 1.02) or ICU (OR, 0.92) mortality was significantly affected by use of on-demand instead of daily chest radiographs. Hospital length of stay, expressed as weighted mean days (WMD), also was not significantly affected (WMD, −0.29 days), and neither was ICU length of stay (WMD, 0.19 days) or days on a ventilator (WMD, 0.33 days). No subgroups of patients were identified for which routine daily chest radiographs offered a benefit.

"Further studies are necessary to identify the specific patient population that would benefit from undergoing daily routine chest radiography and at what time during the course of a patient's care the value of daily radiography diminishes. Meanwhile, protocols that promote undergoing clinically indicated rather than daily routine chest radiography are recommended to reduce unnecessary radiation exposures and health care costs," the authors write.

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