The Usefulness of Routine Preoperative Chest X-rays and ECGs: A Prospective Audit

EHL Lim, EHC Liu
Correspondence: Dr Evangeline Lim, ducktai@singnet.com.sg

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.

Keywords: Electrocardiogram, chest X-ray, pre-operative test, audit
Singapore Med J 2003; 44(7): 340-343