The usefulness of routine preoperative chest X-rays and ECGs: a prospective audit.

ABSTRACT

INTRODUCTION: Pre-operative Chest X-ray (CXR) and electrocardiograms (ECG) are routinely ordered locally for patients above a certain age. This study examines the usefulness of such a practice and its clinical impact. METHODS: Prospective audit of 875 consecutive anaesthetic patients over a one-month period, assessing the proportion and impact of abnormal CXR or ECG findings. RESULTS: The proportion of patients with abnormal CXR or ECG increased with worsening ASA status. There was little impact of routine pre-operative CXR and ECG on anaesthetic management. Only 11/324 CXR and 13/375 ECG affected anaesthetic technique or choice of therapeutic procedure. CONCLUSION: Targeted investigations should be performed as indicated by clinical findings rather than on the basis of arbitrary age cut-offs.