To investigate the diagnostic yield of routine chest X-rays and their impact on management decisions in febrile neutropenic patients with hematological disorders, highlighting the clinical significance.
Key Findings:
41.4% of patients in group A had abnormal chest X-rays compared to 16.1% in group B (P < .001).
Chest CT scans were performed in 51.5% of cases with abnormal X-ray findings.
Antimicrobial treatment decisions were influenced by chest X-ray results in only 6.9% of group A (95% CI: 2.4%–15.6%) and 3.4% of group B (95% CI: 1.9%–5.7%).
Antimicrobial treatment adjustments were more common based on abnormal CT results (17.2% in group A vs. 6.2% in group B, P = .004).
Interpretation:
Chest X-rays have limited diagnostic and therapeutic value in febrile neutropenic patients, particularly those without respiratory symptoms, suggesting they may be safely omitted in such cases, with implications for clinical guidelines.
Limitations:
Retrospective design may introduce bias.
Data limited to a single center, affecting generalizability.
Potential for incomplete data on treatment decisions, including biases in data collection.
Conclusion:
Routine chest X-rays may not be necessary for febrile neutropenic patients without respiratory symptoms, as they rarely influence treatment decisions, potentially impacting clinical practice.
