Impact of preoperative chest X-rays on the surgery of patients at Dr George Mukhari Hospital

Abstract

The purpose of this study was to interrogate the clinical relevance and cost effectiveness of the routine preoperative chest X-rays at DGMH.

It was conducted as a descriptive cross-sectional prospective study of radiographic films in the Radiology department. A review of patients’ files and chest X-rays performed during a 6-month period from January to June 2008.

Data from 100 patients’ files were included in the analysis. The age of patients ranged from 45 to 84years, the median age was 57years. The majority of patients younger than 50years were female, while the majority of male patients were over 50years. From a total of 100 patients only 8%(8 patients) were deemed unfit and consequently postponed or cancelled for further investigation and optimization. The cost for performing one routine chest X-ray was estimated to be R393 manpower, time and film inclusive, the total costs for the 100 patients included in this study being R39300.

This study has provided some evidence that the routine preoperative chest X-rays can help in uncovering some abnormalities that were not apparent on clinical examination, it has pointed out that the impact of these uncovered abnormalities is very minimal on the planned surgery and that the costs associated with doing routine pre-operative chest X-rays can be substantial.