title: The utility of routine admission chest X-ray films on patient care.
abstract: BACKGROUND
  Routine chest X-rays are the most widely obtained radiological studies during hospital admissions. In this study, we evaluated the utility of routine admission chest X-rays on patient care in patients admitted to The Brooklyn Hospital center.
  
  
  METHODS
  We included consecutive patients admitted to the medical floors during a 4-month period who had a chest X-ray done on admission. The medical records of patients who had chest X-ray on admission were reviewed to identify any impact of chest X-ray on patient care during the course of hospitalization.
  
  
  RESULTS
  Chest X-ray was noted to be done in 229 patients on admission. Chest X-rays of 100 (43.6%) patients were deemed medically necessary because of the presenting complaints which included cough (15.2%), fever (13.1%), dyspnea (6.1%), hemoptysis (1.7%), and combined symptoms (7.4%). Routine chest X-rays were done in 129 (56.3%) patients to rule out occult findings in the absence of any symptoms. Chest X-ray abnormalities were noted in 56 of 129 (43.4%) patients. In 51 of 56 patients, abnormalities were chronic, stable and previously known and did not contribute to patient care. In only 5 of 129 (3.87%) patients, there were findings which necessitated a change in patient care.
  
  
  CONCLUSIONS
  We conclude that routine chest films rarely reveal clinically unsuspected findings. The overall impact on patient care based on these findings is small when compared to the risks associated with repeated exposure to radiation. We recommend that routine chest X-ray films should not be ordered solely because of hospital admission.
authors.affiliation: Department of Pulmonary Medicine, The Brooklyn Hospital Center, Affiliate New York Presbyterian Healthcare System, Brooklyn, NY 11201, USA. vishaljagmohan@hotmal.com
authors.forename: Vishal
authors.initials: V
authors.lastname: Verma
authors.forename: Viswanath
authors.initials: V
authors.lastname: Vasudevan
authors.forename: Praveen
authors.initials: P
authors.lastname: Jinnur
authors.forename: Sasikanth
authors.initials: S
authors.lastname: Nallagatla
authors.forename: Ayanava
authors.initials: A
authors.lastname: Majumdar
authors.forename: Farhad
authors.initials: F
authors.lastname: Arjomand
authors.forename: M Scott
authors.initials: MS
authors.lastname: Reminick
mesh_terms: D000208:Acute Disease / Q000191:economics / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching / Q000191:economics / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D013902:Radiography, Thoracic / Q000191:economics / Q000706:statistics & numerical data*; D019564:Unnecessary Procedures / Q000191:economics / Q000706:statistics & numerical data*; D055815:Young Adult