Preoperative chest radiography: value as a baseline examination for comparison.

An important use of the preoperative chest radiograph is as a baseline for comparison when complications occur after surgery. Many authors have commented on the value of preoperative chest radiography as a screening examination, but no statistics have been presented regarding its impact on postoperative management. In 369 consecutive general surgical patients, the need for a baseline chest radiograph was evaluated. In 65 patients undergoing chest radiography postoperatively, a preoperative baseline was essential in making an accurate interpretation in 33 (51%). The value of preoperative chest radiography proved to be twofold. Some minimal abnormalities on postoperative radiographs were demonstrated to be clearly new, necessitating treatment or further evaluation. Second, significant abnormalities detected on postoperative radiographs that may have otherwise been subjected to expensive evaluation were often shown to have been present preoperatively. In approximately 9% of patients the preoperative chest radiograph had a significant impact on postoperative management.