Routine chest radiography in intensive care: impact on decision-making.

OBJECTIVE

This study determined the prevalence of clinical abnormalities in chest radiographs and its relationship with decision-making in intensive care.

METHODS

This prospective cohort study involved nonconsecutive patients who were admitted to the intensive care unit at the Hospital Universitário Professor Polydoro Ernani de São Thiago of the Universidade Federal de Santa Catarina. Imaging tests in the intensive care unit (ICU) were assessed daily between February and May 2011 and divided according to the reason for hospitalization, the type of test requested, anatomical segment under assessment and the purpose of the request. The imaging tests were interpreted by intensivists and subsequently divided according to the detected abnormalities and changes in medical care. The chi-squared test was used for statistical analysis.

RESULTS

The study sample included 106 patients. A total of 447 imaging tests were assessed, 425 of which were anteroposterior chest radiographs. An average of 4.01 radiographs per patient was obtained. Among the requested radiographs, 79.3% were normal, and 35.2% of abnormal radiographs did not prompt changes in medical care.

CONCLUSION

Most of the radiographs performed in the intensive care unit exhibited no statistically significant clinical alterations, and the radiographs that revealed abnormalities did not necessarily lead to changes in medical care.