Routine chest x-rays in intensive care units: a systematic review and meta-analysis

Table 2 Characteristics of included observational (before-after) studies of restrictive versus routine CXR strategies.

Study	ICU Population	Patient selection criteria	Location	Total patients (n)	CXRs/patients, restrictive group (n/n)	CXRs/patients, routine group (n/n)	Outcomes used in meta-analysis
Rao et al., 1997 [17]^a	Post cardiac surgery	Exclusion criteria: ICU length of stay > 36 hours, death within 36 hours	UK	200	36/100	304/100	Hospital length of stay
Price et al., 1999 [18]^b	Pediatric	Exclusion criterion: Cardiothoracic surgical patients	USA	3,427	5,939/1,588	10,585/1,839	ICU and hospital length of stay^c Duration of mechanical ventilation^c
Leong et al., 2000 [19]^d	Post cardiac surgery	All patients included	USA	200	334/100	520/100	Hospital mortality ICU and hospital length of stay Duration of mechanical ventilation
Krinsley et al., 2003 [20]	Medical-surgical, Adult	All patients included	USA	2,564	2,298/1,267	3,093/1,297	Hospital mortality ICU length of stay Duration of mechanical ventilation
Graat et al., 2007 [21]	Medical-surgical, Adult	Exclusion criteria: Readmissions	Netherlands	1,376	1,115/622	3,194/754	ICU and hospital mortality
Hendriske et al., 2007 [22]	Medical-surgical, Adult	Exclusion criteria: Cardiothoracic surgical and neurosurgical patients	Netherlands	736	907/250	1,780/486	Hospital mortality

^aThe study included one group with routine CXRs, a second group with less frequent routine CXRs, and a third group with CXRs ordered only as clinically indicated. We abstracted data from the first and third groups; ^bThis study included a control phase with routine CXRs, an evaluative phase with a small convenience sample of patients with routine CXRs in which the investigators studied the impact of routine CXRs on patient management, and a post intervention phase with no routine CXRs. We abstracted data from the first and third phases; ^cOutcomes data were abstracted from Figure 5; ^dThis study included a control group with routine daily CXRs, a second group with CXRs ordered when clinically indicated and routine CXRs only on admission and after extubation (two months after the change was implemented), and a third group with the same CXR strategy as the second group studied 4 years after the change was implemented. We abstracted data from the first and third groups. CXR, chest X-ray; n, number.

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