요오드화 조영제 이상반응 전산 관리시스템의 영향
Effects of an electronic system for the management of adverse reactions to iodinated contrast media
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Purpose: In 2014, Pusan National University Hospital developed an electronic system for the monitoring and management of adverse drug reactions (ADRs) to iodinated contrast media (ICM) and premedication. We analyzed the prevalence of hypersensitivity reactions (HRs) and the effect of premedication after system development. Methods: We analyzed immediate HRs to ICM recorded from January 2015 to September 2018 and the annual incidences were compared. Results: Patients with immediate HRs to ICM were at a mean age of 54.6±14.3 years and 53.8% were female. The overall frequency of HRs was 0.328%. In the classification according to the degree of severity, 87.2% of the cases were mild, 11.0% were moderate, and 1.8% were severe. The ICM most commonly inducing an HR was iomeprol (0.529%), followed by iohexol (0.371%), ioversol (0.359%), iobitridol (0.310%), iopamidol (0.152%), iopromide (0.128%), and iodixanol (0.036%). ICM was readministered to 49.2% of the patients, and immediate HRs recurred in 16.2%. There was no correlation between premedication with an antihistamine and HR recurrence, but premedication with corticosteroids reduced the rate significantly. After development of the electronic monitoring and management system, the HR incidence increased 1.25-fold per year, but most cases were mild and the rate of severe reactions tended to decrease. Conclusion: Because ADRs to ICM are difficult to predict, appropriate strategies to prevent their development are needed. A system that documents ADRs to ICM can improve patient management.
Abstract
Purpose: In 2014, Pusan National University Hospital developed an electronic system for the monitoring and management of adverse drug reactions (ADRs) to iodinated contrast media (ICM) and premedication. We analyzed the prevalence of hypersensitivity reactions (HRs) and the effect of premedication after system development. Methods: We analyzed immediate HRs to ICM recorded from January 2015 to September 2018 and the annual incidences were compared. Results: Patients with immediate HRs to ICM were at a mean age of 54.6±14.3 years and 53.8% were female. The overall frequency of HRs was 0.328%. In the classification according to the degree of severity, 87.2% of the cases were mild, 11.0% were moderate, and 1.8% were severe. The ICM most commonly inducing an HR was iomeprol (0.529%), followed by iohexol (0.371%), ioversol (0.359%), iobitridol (0.310%), iopamidol (0.152%), iopromide (0.128%), and iodixanol (0.036%). ICM was readministered to 49.2% of the patients, and immediate HRs recurred in 16.2%. There was no correlation between premedication with an antihistamine and HR recurrence, but premedication with corticosteroids reduced the rate significantly. After development of the electronic monitoring and management system, the HR incidence increased 1.25-fold per year, but most cases were mild and the rate of severe reactions tended to decrease. Conclusion: Because ADRs to ICM are difficult to predict, appropriate strategies to prevent their development are needed. A system that documents ADRs to ICM can improve patient management.
참고문헌 (22)
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