Value of routine preoperative chest x-rays: a meta-analysis

Archer, Chantai; Levy, Adrian R.; McGregor, Maurice

doi:10.1007/bf03009471

Cited by 136 publications

(50 citation statements)

References 28 publications

(5 reference statements)

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“…A meta-analysis of studies involving 14,390 preoperative chest radiographs found that only 14 cases with chest radiographs were unexpectedly abnormal and management was changed [67]. Another study demonstrated that, despite a lower rate of PPCs in patients who received preoperative chest radiograph (12.8% vs 16%), only 1–4% of the patients' managements were altered due to the result of chest radiograph [68].…”

Section: Risk Factors For Ppcsmentioning

confidence: 99%

Pre-operative pulmonary assessment for patients with hip fracture

Siu

Tse

et al. 2010

Osteoporos Int

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Hip fracture is a common injury among the elderly. Although patients who receive hip fracture surgery carry the best functional recovery compared to other treatment modalities, the presence of postoperative pulmonary complications, such as atelectasis, pneumonia, and pulmonary thromboembolism, may contribute to increased length of hospital stay, perioperative morbidity, and mortality. This review aims to provide evidence-based recommendations for preoperative assessment and perioperative strategies to reduce the risk of pulmonary complications after hip fracture surgery. Clinical assessment and basic laboratory results are sufficient to stratify the risk of postoperative pulmonary complications. Well-documented risk factors for pulmonary complications include advanced age, poor general health status, current infections, pre-existing cardiopulmonary diseases, hypoalbuminemia, and impaired renal function. Apart from optimizing the patient's medical conditions, interventions such as lung expansion maneuvers and thromboprophylaxis have been proven to be effective in reducing the risk of pulmonary complications after hip fracture surgery.

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Section: Risk Factors For Ppcsmentioning

confidence: 99%

Pre-operative pulmonary assessment for patients with hip fracture

Siu

Tse

et al. 2010

Osteoporos Int

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“…Per cutaneous coronary catheterization (PCI) within 90 min in ST elevation myocardial infarction (STEMI) [4] Preventive aspirin therapy for patients with acute MI [5] Preventive statins therapy for patients with acute MI [6] Performance evaluation of risk of stroke in patients with atrial fibrillation [7] Evaluation of Padua score for prevention of venous thrombosis [8] Carotid arteries duplex within 72 h of admission to the emergency department due to transit ischemic attack [9] TPA or neuro-angiography after acute CVA [10] Preventive antibiotic treatment an hour before colectomy [11] Operation of hip fracture within 48 h of admission [12] Antibiotic prophylaxis before hip surgery [13] Preventive antibiotic treatment before Cesarean section [14] Preventive anti-thrombotic treatment before hysterectomy [15] Steroids therapy for women at risk of preterm delivery [16] Hospitalization within two weeks after gynecologic elective surgery [17] Hospitalization within two weeks after elective cesarean section [18] Readmissions to the emergency department within 24 h [19] Computing diagnosis in the emergency department, brain CT or MRI in acute CVA within 25 min of arrival to the emergency department [20] Chest x-rays interpretation NA Central line associated bloodstream sepsis (CLABSI) for 1,000 catheter-days [21] Clostridium difficile incidence for 1,000 hospitalization days [22] Falls for 1000 hospitalization days [23] Falls with severe damage for 1000 hospitalization days [24] Acquired pressure sore [24] Computing main diagnosis in the digital patient's file NA Longer hospitalization of more than 8 days following colectomy for colorectal cancer [25] Readmission within 2 weeks after trans urethral prostatectomy [26] Planned patient's discharge NA…”

Section: Indicator Referencesmentioning

confidence: 99%

Establishing an Integrated Quality Assurance and Patient's Safety Service in a Tertially, Academic Medical Center

Yaron¹,

Berkov²,

Chorev³

et al. 2017

Health Care Current Reviews

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Background: Clalit Health Services (CHS) is a large health care provider for 4.6 million enrollees in Israel. This is the country's largest medical organization with an annual budget of approximately 17 billion New Israeli Shekel (NIS). Rabin Medical Center comprising Beilinson and HaSharon hospitals is the biggest medical center of CHS, an academic, tertially, referral center, with 1200 beds, including all services of a modern hospital. Aim:To describe the establishment process of integrated quality assurance and patient's safety service and to evaluate its success in 4 years of activity. Quality indicators (process and outcome) were developed and monitored. Improvement was assessed by comparing the results of 2013 and 2016 indicators. Methods:We believe in "No blame or shame" and "To err is human" strategy. The patient is always in the center, continuous learning is being conducted with conclusions and improvement plans, implementation and systematic approach, measuring and proactive activity to improve patient safety. We used Plan Do Check Act (PDCA) cycle in most of the processes. Results:We established 4 units: quality assurance, risk management, regulation committee for policy, strategic affairs and legal aid, and unit of quality indicators and quality working plans. Quality improvement plan was performed every year. We demonstrated a significant improvement in most of the quality indicators measured. Conclusion:Organizational changes focused on patient safety, based on clinical protocols, quality indicators and special committees, brought the hospital to new, high level, achievements. We believe that our patients enjoy high level quality of care in the hospital safe environment.

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“…Laboratory analyses that investigate pathological conditions are requested based on the anamnesis and physical examination findings. Chest x-ray should be considered for high-risk patients over the age of 50 years and for patients thought to have cardiac or pulmonary disease [62]. Pulmonary function test is recommended before all kinds of surgery in patients having dyspnea and exercise intolerance.…”

Section: Things To Do When Consultation Is Requested For the Patientmentioning

confidence: 99%