Daily Chest X-Rays the Norm for Many Patients on Mechanical Ventilation

The majority of patients requiring mechanical ventilation (MV) receive daily chest radiographs (CXRs), although the number is dropping following new guidelines, according to a study published online in JAMA Network Open.

Researchers from the United States and Canada performed a retrospective cohort study to determine frequency of daily CXR use for U.S. patients receiving MV, assess variability across hospitals, and evaluate whether use has decreased over time.

The primary cohort included 512,518 hospitalized adults from 416 hospitals receiving MV for 3 days or longer; 321,093 (63 percent) received daily CXRs. The patients’ mean age was 63 years, 46 percent of the patients were female. The outcome was daily chest radiograph use, for up to 7 days.

There was a wide variability across hospitals. Hospitals performed daily CXRs on a median of 66 percent of patients. The adjusted median OR was 2.43, suggesting the same patient had 2.43-fold higher odds of receiving a daily CXR if admitted to a higher- versus lower-use hospital; the odds of receiving daily CXRs were unchanged through quarter 3 of 2011, after which there was a 3 percent relative reduction in the odds of daily CXR use per quarter.

The researchers concluded that three-fifths of U.S. patients receiving MV also received daily CXRs from 2008 to 2014, although use declined slowly after new guidelines were published. The hospital at which a patient received care was associated with the odds of daily CXR receipt.