ePoster #18 | Over-Utilization of Chest X-rays in the Trauma Intensive Care Unit

Clinical Science | Trauma


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.