Comparison of postoperative cardiopulmonary examinations and chest radiographs to detect pulmonary complications after adult tracheotomy

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Abstract

OBJECTIVE: To prospectively evaluate the effectiveness of clinical cardiopulmonary examination compared with that of chest radiography in detecting postoperative pulmonary complications after tracheotomy in adults. METHODS: One hundred consecutive patients undergoing tracheotomy were evaluated. Pulmonary complications were recorded, and the effectiveness of the physical examination was compared with that of the chest x-ray in detecting these complications. Patient age, sex, diagnosis, urgency of the procedure, and anesthetic technique were evaluated to determine any relationship to postoperative complications. RESULTS: Of the 100 patients, 87 patients underwent postoperative chest radiography, and all patients had postoperative cardiopulmonary examinations. One patient (1%) had a bilateral pneumothorax, which was detected clinically and confirmed by a chest radiograph. Five patients had postoperative pulmonary edema confirmed by clinical examination and radiography. Additional minor complications were noted, including minor bleeding and stomal infection, for an overall complication rate of 13%. CONCLUSIONS: All postoperative pulmonary complications were detected by physical examination. Therefore routine postoperative chest radiographs in uncomplicated tracheotomies are not necessary if a thorough postoperative cardiopulmonary examination is performed. Cost analysis reveals a savings of approximately $19,000 with the proposed criteria for postoperative chest x-ray.

Original languageEnglish (US)
Pages (from-to)274-276
Number of pages3
JournalOtolaryngology - Head and Neck Surgery
Volume121
Issue number3
DOIs
StatePublished - 1999

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Tracheotomy
Thorax
Lung
Radiography
Physical Examination
X-Rays
Pneumothorax
Pulmonary Edema
Anesthetics
Hemorrhage
Costs and Cost Analysis
Infection

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

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title = "Comparison of postoperative cardiopulmonary examinations and chest radiographs to detect pulmonary complications after adult tracheotomy",
abstract = "OBJECTIVE: To prospectively evaluate the effectiveness of clinical cardiopulmonary examination compared with that of chest radiography in detecting postoperative pulmonary complications after tracheotomy in adults. METHODS: One hundred consecutive patients undergoing tracheotomy were evaluated. Pulmonary complications were recorded, and the effectiveness of the physical examination was compared with that of the chest x-ray in detecting these complications. Patient age, sex, diagnosis, urgency of the procedure, and anesthetic technique were evaluated to determine any relationship to postoperative complications. RESULTS: Of the 100 patients, 87 patients underwent postoperative chest radiography, and all patients had postoperative cardiopulmonary examinations. One patient (1{\%}) had a bilateral pneumothorax, which was detected clinically and confirmed by a chest radiograph. Five patients had postoperative pulmonary edema confirmed by clinical examination and radiography. Additional minor complications were noted, including minor bleeding and stomal infection, for an overall complication rate of 13{\%}. CONCLUSIONS: All postoperative pulmonary complications were detected by physical examination. Therefore routine postoperative chest radiographs in uncomplicated tracheotomies are not necessary if a thorough postoperative cardiopulmonary examination is performed. Cost analysis reveals a savings of approximately $19,000 with the proposed criteria for postoperative chest x-ray.",
author = "Park, {Steven Y.} and Smith, {Richard V.}",
year = "1999",
doi = "10.1016/S0194-5998(99)70184-1",
language = "English (US)",
volume = "121",
pages = "274--276",
journal = "Otolaryngology - Head and Neck Surgery (United States)",
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TY - JOUR

T1 - Comparison of postoperative cardiopulmonary examinations and chest radiographs to detect pulmonary complications after adult tracheotomy

AU - Park, Steven Y.

AU - Smith, Richard V.

PY - 1999

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N2 - OBJECTIVE: To prospectively evaluate the effectiveness of clinical cardiopulmonary examination compared with that of chest radiography in detecting postoperative pulmonary complications after tracheotomy in adults. METHODS: One hundred consecutive patients undergoing tracheotomy were evaluated. Pulmonary complications were recorded, and the effectiveness of the physical examination was compared with that of the chest x-ray in detecting these complications. Patient age, sex, diagnosis, urgency of the procedure, and anesthetic technique were evaluated to determine any relationship to postoperative complications. RESULTS: Of the 100 patients, 87 patients underwent postoperative chest radiography, and all patients had postoperative cardiopulmonary examinations. One patient (1%) had a bilateral pneumothorax, which was detected clinically and confirmed by a chest radiograph. Five patients had postoperative pulmonary edema confirmed by clinical examination and radiography. Additional minor complications were noted, including minor bleeding and stomal infection, for an overall complication rate of 13%. CONCLUSIONS: All postoperative pulmonary complications were detected by physical examination. Therefore routine postoperative chest radiographs in uncomplicated tracheotomies are not necessary if a thorough postoperative cardiopulmonary examination is performed. Cost analysis reveals a savings of approximately $19,000 with the proposed criteria for postoperative chest x-ray.

AB - OBJECTIVE: To prospectively evaluate the effectiveness of clinical cardiopulmonary examination compared with that of chest radiography in detecting postoperative pulmonary complications after tracheotomy in adults. METHODS: One hundred consecutive patients undergoing tracheotomy were evaluated. Pulmonary complications were recorded, and the effectiveness of the physical examination was compared with that of the chest x-ray in detecting these complications. Patient age, sex, diagnosis, urgency of the procedure, and anesthetic technique were evaluated to determine any relationship to postoperative complications. RESULTS: Of the 100 patients, 87 patients underwent postoperative chest radiography, and all patients had postoperative cardiopulmonary examinations. One patient (1%) had a bilateral pneumothorax, which was detected clinically and confirmed by a chest radiograph. Five patients had postoperative pulmonary edema confirmed by clinical examination and radiography. Additional minor complications were noted, including minor bleeding and stomal infection, for an overall complication rate of 13%. CONCLUSIONS: All postoperative pulmonary complications were detected by physical examination. Therefore routine postoperative chest radiographs in uncomplicated tracheotomies are not necessary if a thorough postoperative cardiopulmonary examination is performed. Cost analysis reveals a savings of approximately $19,000 with the proposed criteria for postoperative chest x-ray.

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