{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T23:27:41Z","timestamp":1773271661481,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,5,19]],"date-time":"2014-05-19T00:00:00Z","timestamp":1400457600000},"content-version":"vor","delay-in-days":48,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>For many years, routine post\u2010tracheostomy chest<jats:styled-content style=\"fixed-case\">X<\/jats:styled-content>\u2010ray has been the standard of care for patients in many countries. However, recent evidence suggests that this is unnecessary and cost\u2010ineffective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To review the current literature and examine the role of routine post\u2010tracheostomy chest<jats:styled-content style=\"fixed-case\">X<\/jats:styled-content>\u2010ray in adult patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Type of review<\/jats:title><jats:p>Systemic review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Search strategy<\/jats:title><jats:p>Electronic databases (PubMed,<jats:styled-content style=\"fixed-case\">EMBASE<\/jats:styled-content>, Cochrane) were searched using the keywords \u2018chest<jats:styled-content style=\"fixed-case\">X<\/jats:styled-content>\u2010ray\/radiography\/radiograph\u2019 and \u2018tracheostomy\/tracheotomy\u2019 in various permutations. Search period ranged from 1960 to 2012. Inclusion criteria included systematic reviews, meta\u2010analyses, randomised control trials, prospective and retrospective case series. Paediatric and non\u2010English articles were excluded. Abstracts and subsequently full text articles were screened by two of the authors independently. References from obtained articles were also examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Evaluation method<\/jats:title><jats:p>Specific outcome measures were collated to evaluate the usefulness of post\u2010tracheostomy chest X\u2010ray:<jats:list><jats:list-item><jats:p>Chest X\u2010ray detected (tracheostomy\u2010related) complication rates<\/jats:p><\/jats:list-item><jats:list-item><jats:p>Proportion of cases requiring significant intervention<\/jats:p><\/jats:list-item><jats:list-item><jats:p>Potential predictors of complications<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Routine post\u2010tracheostomy chest<jats:styled-content style=\"fixed-case\">X<\/jats:styled-content>\u2010ray is of a low yield, and its findings had limited impact on patient management. Complication detection rates for surgical and percutaneous tracheostomy are 2.2% and 3.2%, respectively. Only 0.7% and 1.8% of chest<jats:styled-content style=\"fixed-case\">X<\/jats:styled-content>\u2010rays performed in surgical and percutaneous tracheostomy cases, respectively, required intervention. Certain groups of patients, however, are at higher risks of complications, and may benefit from post\u2010tracheostomy chest<jats:styled-content style=\"fixed-case\">X<\/jats:styled-content>\u2010ray. For surgical tracheostomy, these groups include those with post\u2010operative signs and symptoms of complications or had emergent or \u2018difficult\u2019 tracheostomies. For percutaneous tracheostomy, high\u2010risk patients include trauma cases (unspecified), patients with post\u2010procedural signs and symptoms of complications, patients who have high ventilatory requirements, difficult tracheostomy cases or tracheostomy cases performed without bronchoscopic guidance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The practice of routine post\u2010tracheostomy chest<jats:styled-content style=\"fixed-case\">X<\/jats:styled-content>\u2010ray is debatable owing to its low yield and minimal impact on clinical management. However, certain groups of patients appear to be at higher risks of post\u2010tracheostomy complications; currently, there is insufficient evidence to conclude the absolute need for routine chest<jats:styled-content style=\"fixed-case\">X<\/jats:styled-content>\u2010ray in these groups of patients, although it may be prudent to do so based on available evidence in the literature and logical clinical reasoning.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.12233","type":"journal-article","created":{"date-parts":[[2014,2,27]],"date-time":"2014-02-27T15:23:48Z","timestamp":1393514628000},"page":"79-88","source":"Crossref","is-referenced-by-count":17,"title":["Is routine chest<scp>X<\/scp>\u2010ray after surgical and percutaneous tracheostomy necessary in adults: a systemic review of the current literature"],"prefix":"10.1111","volume":"39","author":[{"given":"W.X.","family":"Yeo","sequence":"first","affiliation":[{"name":"Ministry of Health Holdings Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.Q.","family":"Phua","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Tan Tock Seng Hospital Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Tan Tock Seng Hospital Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,5,19]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"218","article-title":"Complications of emergency and elective tracheostomy: a retrospective study of 150 consecutive cases","volume":"72","author":"Waldron J.","year":"1990","journal-title":"Ann. 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