The efficacy of X-rays after chest tube removal

BACKGROUND: The insertion and subsequent removal of chest tubes are frequen tly performed procedures. We hypothesize that routine chest radiographs obt ained after chest tube removal to confirm the absence of any post-procedure complications have little impact on clinical management. MATERIALS AND METHODS: A 5-year retrospective study of 73 patients with tub e thoracostomies was performed in a level II trauma center's intensive care unit. Patients were identified from billing records for chest tube placeme nt. Medical records and official chest x-ray film reports, both before and after removal, were reviewed, and demographic data were collected. RESULTS: Of the 73 patients examined, only 8 had postprocedure reports that differed from the preprocedure reports. Two of these 8 patients required r einsertion of a chest tube to treat the recurrence of a significant pneumot horax. However, the decision to reinsert the chest tube was based on the pa tient's clinical appearance rather than on the x-ray findings. CONCLUSION: Chest radiography following the removal of chest tubes should n ot be a routinely performed procedure, but should preferably be based on th e good clinical judgement and discrimination of the surgeon. (C) 2000 by Ex cerpta Medica, Inc.