Evaluation of Pre‐Operative Chest X‐Ray

The study assesses the value of pre‐operative chest x‐rays in a group of 500 adult patients. The frequency of detected abnormalities has been shown to be age related, with a significant increase in the over 50 age group. The most frequent abnormalities were cardiomegaly (23%) and chronic obstructive pulmonary disease (6.8%). Thirty‐three patients had abnormalities thought to be of significance in planned surgery or anaesthesia. Of these, four had surgery cancelled (3 with evidence of metastatic disease, 1 with severe emphysema) and one had palliative surgery (metastatic disease). One patient had surgery postponed due to workup of a suspicious rib lesion. It is important to curb unnecessary health costs and to justify investigations in terms of patient benefits and cost effectiveness. If preoperative chest x‐rays were limited to the over 50 age group or to patients with clinical features of cardiac, pulmonary or malignant disease, it is unlikely that significant disease will be missed.