title: [Chest X-ray interpretation on patients admitted in a short-stay unit. Relation with the mean length of stay].
abstract: BACKGROUND
  To assess the agreement between physicians of the emergency department and a radiologist in the interpretation of chest roentgenograms in patients admitted to the short-stay unit, and to determine the effect of concordance on the mean length of stay.
  
  
  METHODS
  The medical records of patients admitted to the short-stay unit over a 4-month period were reviewed. The interpretation of the chest X-ray film made by the physician in charge of the patient at the emergency department with that made by the radiologist was compared. The mean length of stay was determined and it was analyzed if the reading of the radiograph made by the radiologist before admission would decrease the length of stay.
  
  
  RESULTS
  A total of 260 medical records were reviewed. The overall degree of agreement was 74.2% but it was greater when the physician at the emergency department was a staff physician or a resident in the final period of training than a resident in the initial period of training (82% vs 66.4%, p < 0.003). There were no statistically significant differences regarding the day hours at which readings were made. A change in the diagnosis and/or treatment of the patient would had occurred in only 9 cases (3.5%). There were no changes in the mean length of stay according to the presence or absence of concordance, although there was a trend towards an increase in the length of stay for those cases in which diagnosis and/or treatment would had been different.
  
  
  CONCLUSIONS
  Readings of chest roentgenograms by a radiologist before admission to a short-stay unit does not appear to be justified for all patients, although it may be justified when a staff physician or a resident in the final period of training have doubts regarding interpretation of the radiographic images. A better supervision of residents in the initial period of training may contribute to improve the diagnostic reliability of chest X-ray films.
authors.affiliation: Servicio de Urgencias y Radiología, Hospital Universitario del Mar, Barcelona, Spain. Asupervia@imas.imim.es
authors.forename: A
authors.initials: A
authors.lastname: Supervía Caparrós
authors.forename: M D
authors.initials: MD
authors.lastname: Aranda Cárdenas
authors.forename: J
authors.initials: J
authors.lastname: Royo Lazaro
authors.forename: J
authors.initials: J
authors.lastname: Martínez Orfila
authors.forename: M A
authors.initials: MA
authors.lastname: Márquez Lorente
authors.forename: E
authors.initials: E
authors.lastname: Skaf Peters
authors.forename: J
authors.initials: J
authors.lastname: Gutiérrez Cebollada
mesh_terms: D000368:Aged; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data*; D015588:Observer Variation; D013902:Radiography, Thoracic / Q000706:statistics & numerical data*