Preoperative chest x-ray films in elective surgery: a valid screening tool.

The authors reviewed retrospectively 1000 patients who had a preoperative chest x-ray film made and who underwent elective surgery. Results showed that 5.8% of women and 10.5% of men (7.4% of all patients) had an abnormal preoperative chest x-ray film. These abnormalities were much more frequent (30%) in patients over 50 years of age than in younger patients (3%). Of the 74 patients whose films revealed abnormalities, 68 (92%) had a history or symptoms of cardiorespiratory disease. Of the six patients with x-ray film abnormalities but without symptoms or a pertinent history, none had a change in clinical outcome because of radiography. Guidelines are recommended for selectively ordering preoperative chest x-rays in surgical patients.