Ruza Gustavo Catalan, Moritz Rachel Duarte, Machado Fernando Osni
Rev Bras Ter Intensiva. 2012 Sep;24(3):252-7.
This study determined the prevalence of clinical abnormalities in chest radiographs and its relationship with decision-making in intensive care.
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.
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.
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.
本研究确定胸部X光片中临床异常的发生率及其与重症监护决策的关系。
这项前瞻性队列研究纳入了圣卡塔琳娜联邦大学波尔迪多罗·埃纳尼·德·圣蒂亚戈大学医院重症监护病房的非连续患者。2011年2月至5月期间，每天对重症监护病房（ICU）的影像检查进行评估，并根据住院原因、检查类型、评估的解剖部位和检查目的进行分类。影像检查由重症监护医生解读，随后根据检测到的异常情况和医疗护理的变化进行分类。采用卡方检验进行统计分析。
研究样本包括106名患者。共评估了447项影像检查，其中425项为胸部前后位X光片。每位患者平均获得4.01张X光片。在要求进行的X光片中，79.3%为正常，35.2%的异常X光片未促使医疗护理发生变化。
重症监护病房进行的大多数X光片检查在临床上无统计学显著改变，而显示异常的X光片不一定会导致医疗护理的改变。
