Limited Clinical Utility of Chest Radiography in Asymptomatic Patients after Interventional Radiology-Performed Ultrasound-Guided Thoracentesis: Analysis of 3,022 Consecutive Patients

Abstract Purpose The aim of this study was to report the utility chest radiography following interventional radiology-performed ultrasound-guided thoracentesis. Materials and Methods A total 3,998 patients underwent thoracentesis between 2003 2018 at two institutions. 3,022 (75.6%) were older than 18 years old, thoracentesis, had same-day post-procedure radiograph evaluation. Patient age (years), laterality procedural technical success, volume fluid removed (mL), method imaging, absence or presence pneumothorax, pneumothorax size (mm), management measures, clinical outcomes recorded. Technical success defined as successful aspiration pleural fluid. Post-procedure included new patient-perceived dyspnea hypoxia (oxygen saturations < 90% on room air). Costs associated with radiographs estimated using Medicare Medicaid fee schedules. Results Mean 56.7 ± 15.5 years. Interventional performed left (n = 1,531; 50.7%), right 1,477; 48.9%), bilaterally 14; 0.5%) 5-French catheters. 100% 3,022). 940 550 mL removed. imaging in form posteroanterior (PA) (2.6%; 78/3,022), anteroposterior (AP) (17.0%; 513/3,022), PA lateral (77.9%; 2,355/3,022), PA, lateral, decubitus (2.5%; 76/3,022) radiographs. Post-procedural identified 21 (0.69%) patients. size, measured longest distance from wall lung, 18.8 10.2 mm (range: 5.0–35.0 mm). Of pneumothoraces, 7 (33.3%) asymptomatic, resolved spontaneously, a mean 6.4 2.4 mm. Fourteen 25.0 5.8 mm, required drainage catheter (66.6%). overall incidence requiring placement 0.46% (14/3,022). placement, 12/14 (85.7%) 13/14 (92.9%) hypoxia, respectively. Potential costs Medicaid, for radiographs, study, $27,547 $10,581, Conclusion clinically significant radiology-operated is exceedingly low (0.46%), routine asymptomatic provide little value. Reserving will result more efficient resource utilization health care cost savings.