ePoster #18 | Over-Utilization of Chest X-rays in the Trauma Intensive Care Unit
Clinical Science | Trauma
OVER-UTILIZATION OF CHEST X-RAYS IN TRAUMA ICU PATIENTS
Kathryn Rhymes, MD, Navdeep Samra, MD FACS
ePoster Presenter: Kathryn Rhymes MD, LSU Health – Shreveport
Background: Chest X-rays are one of the most common radiologic studies ordered in the ICU setting. Prior studies have shown that the diagnostic and therapeutic value of routine daily chest x-rays is low and eliminating daily chest x-rays does not adversely affect patient safety.
Objectives: The purpose our study is to examine the utilization of routine chest x-rays in the trauma ICU patients at a single institution.
Methods: IRB approved retrospective chart review from October 2018 to October 2019 of trauma patients admitted to the trauma ICU who were intubated during their hospital course. Chest x-ray orders reviewed and categorized between indication based versus routine. Patient data including age, injury severity score, chest trauma, thoracic surgical procedures, chest tubes and tracheostomy was also recorded.
Results: Seventy patient charts reviewed. Total number of chest x-rays performed 1587 with 505 (32%) recorded as indication based while 1082 (68%) ordered as routine. 46 male and 24 female patients. Mean age is 53.97 (min 22, max 85 with a standard deviation of 19). Mean ISS 23 (standard deviation 13).
Conclusion: A disproportionate amount of CXRs ordered for trauma ICU patients were routine and not indication based. Prior studies have shown a 22% decrease in number of CXRs ordered after implementing an indication based ordering protocol . Applying this to our numbers would result in $69,828 to 139,656 in reduction of costs.