Chest x-ray is widely used as screening before cardiac surgery. The purpose ofthis study was to investigate how often thisleads to relevant information affecting clinical management.

1,136 patients from a tertiary referral center who were scheduled for cardiac surgery were included. Surgeries were performed between 2011-2015. To determine if the chest x-ray showed abnormalities and if these findings had clinical consequences, radiology reports, medical records and discharge letters were analyzed. We also determined if any other chest x-rays or cardiac/chest computed tomography (CT) acquisitions were performed in the year prior to surgery and if there was a relation between an abnormal chest x-ray and postoperative complications.

Baseline characteristics are provided in Table 1. The chest x-ray was considered abnormal in 9.9% (112/1,136) patients (Figure 1). The three most common abnormalities werea possible mass (42/1,136; 3.7%), consolidation (19/1,136; 1.7%) or pleural effusion (42/1,136; 3.7%). Additional test or referral to a specialist based on those findings occured in 17 patients (17/1,136; 1.5%). The surgical strategy was altered in one patient, due to extensive aortic calcifications noted on the chest x-ray and subsequent CT. Surgery was postponed in two patients due to suspected previously...

The yield of a routine chest x-ray before cardiac surgery is very limited with regard to abnormal findings requiring a change in clinical management. However, an abnormal chest X-ray is associated with a prolonged stay in the intensive care unit.