Routine preoperative chest roentgenogram and its impact on intraoperative complications.

Routine preoperative chest X-rays and operative complications were studied in the patients at Songklanagarind Hospital from January 1990 to December 1991. Preoperative chest X-rays was performed in 9583 patients (87.5%). Only patients over 15 years old are included in our studies. Patients undergoing Caesarean section, cardiothoracic surgery and emergency patients were excluded. The studied population were 6347. Chest X-rays abnormalities were found in 9.8 percent of the investigated patients (625 from 6347). The percentage of patients with chest X-rays abnormalities increase 4 folds in patients in those with age group greater than 45 years when compared to the other young groups. The prevalence of tuberculosis in our patients was 1.2 per cent (76 over 6347). Age could be one of the important factors associated with the risk of intraoperative respiratory and cardiovascular complications. Chest X-rays abnormalities did not associated with respiratory complication. The risk of intraoperative cardiovascular complications (arrhythmia, hypertension and/or hypotension) increased in group with chest film abnormalities and age over 45 years. Chest X-rays investigation is not necessary for routine preoperative investigations in patients under 45 years except those with previous history of heart and lung diseases or clinical indications.