title: [Utility of preoperative chest radiography in smokers undergoing transurethral resection of urinary bladder tumors].
abstract: OBJECTIVE
  To assess the utility of preoperative chest radiographic findings for predicting cardiopulmonary complications in smokers undergoing transurethral resection of urinary bladder tumors under spinal anesthesia. To analyze perioperative changes in attitude in this setting.
  
  
  METHODS
  Prospective study of 309 smokers with > or = 20 pack-years of cumulative smoking who were candidates for transurethral resection of urinary bladder tumors. The patients were classified in 2 groups according to radiographic findings. Between groups we compared the incidence of cardiopulmonary complications, perioperative changes in attitude to anesthesia and surgery, delays in completing the preanesthesia workup, and differences in the duration of surgery and hospital stay.
  
  
  RESULTS
  Patients older than 65 years were 1.92 times more likely to have significant findings on the chest radiograph. Radiographic findings were associated with a higher incidence of perioperative complications (P=.02), need for further preoperative consultations (P<.01), longer delay in completing the preanesthesia study (P<.01), longer mean (SD) hospital stay (3.43 [3.17] days vs 2.50 [1.77] days, P<.001), and longer duration of surgery (P<.001). Attitudes did not change in relation to radiographic findings during or after surgery. Chest radiography correctly classified 3.54% of the patients with complications (predictive value).
  
  
  CONCLUSIONS
  The predictive value of chest radiography for cardiopulmonary complications is low and findings do not influence intra- or postoperative attitudes. We therefore find no justification for performing chest x-rays in the population studied.
authors: Servicio de Anestesiologia y Reanimacidn del Hospital General, Hospitales Universitarios Virgen del Rocio, Sevilla. mdlmattam@hotmail.com
authors: M
authors: M
authors: De la Matta Martín
authors: A
authors: A
authors: Herrera González
authors: J A
authors: JA
authors: López Conejos
authors: J L
authors: JL
authors: López Romero