Elimination of routine chest radiographs following off-pump coronary artery bypass surgery: A randomized controlled trial study

Authors
Seyed Khalil Forouzannia 1
Ali Sarvi 2
Mohammadtaghi Sarebanhassanabadi 3
Reza Nafisi-Moghadam 4
1 Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
2 Department of Medicine, Islamic Azad University, Yazd Branch, Yazd, Iran
3 Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
4 Department of Radiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Abstract
Background: Post cardiac surgery routine chest radiographs (CXRs), ordered without any clinical and laboratory indications, is a standard obligatory practice in many cardiothoracic centers. Routine CXRs incur cost, manpower, and radiation. The objective of this study is to assess early outcome in off-pump coronary artery bypass (OPCAB) patients with postoperative routine versus clinically indicated CXR protocols.
Materials and Methods: This study is a randomized clinical trial conducted on 231 OPCAB candidates in Afshar Cardiac Center, Yazd, Iran. Patients were categorized into two groups. All 118 patients in group A had routine postoperative CXRs. The 113 patients in group B were selectively exposed to CXR only on clinical indications. All patients were postoperatively followed up for 30 days. Data gathered from both groups were statistically analyzed.
Results: Routine postoperative CXRs obtained in 118 OPCAB group A candidates showed abnormal findings in 20 patients that did not require new intervention. One month follow-up of these patients showed no complications. In 113 OPCAB candidates of group B, 7 on-demand CXRs were obtained on clinical evaluation that required added intervention. In a 1-month follow-up of this group, five patients presented with symptomatic complaints. On re-examination, none needed readmission, intervention, or paraclinical evaluation. No complications were observed due to CXR elimination.
Conclusion: The study suggests that postoperative CXR selected on clinical grounds in place of routine CXR does not change early postoperative outcome of OPCAB procedure.

Keywords

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Advanced Biomedical Research
Volume 2015, october
October 2015
Pages 1-4