Risk Factors for Adverse Reactions to Iodinated Contrast Media in Computed Tomography
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Objective: The increasing use of imaging examinations such as computed tomography (CT) results in increased contrast media use, which increases contrast media-induced adverse reactions (AR). This study investigated the risk factors of ARs to nonionic iodinated contrast media. Methods: This study evaluated patients who were administered iodinated contrast media during CT scanning in Yeouido St. Mary's Hospital in Seoul, Korea in 2012. Among the subjects, those with contrast media-induced ARs were classified as the AR group. The control group included individuals without ARs who were selected through simple random sampling. The effects of sex, age, contrast media type and dose, CT region, previous contrast media administration, allergy history, and comorbidity were analyzed in the AR and control groups. Results: Multivariate logistic regression analyses were performed to evaluate the identified AR risk factors in 103 subjects in the AR group and 412 subjects in the control group. The results confirmed that the risk of developing ARs was significantly higher in females [odds ratio (OR): 2.206; 95% confidence interval (CI): 1.353- 3.598], in individuals administered Iohexol (OR: 9.981; 95% CI: 2.361-42.193), in individuals with an allergy history (OR: 3.982; 95% CI: 1.742-9.101), and in individuals with comorbid asthma (OR: 6.619; 95% CI: 1.377-31.826). Most of the ARs were mild and immediate. Conclusion: In patients who were administered contrast media during CT scans, female gender, Iohexol use, allergy history, and asthma were risk factors for ARs. Therefore, special care is required for patients with such risk factors to prevent ARs.
Abstract
Objective: The increasing use of imaging examinations such as computed tomography (CT) results in increased contrast media use, which increases contrast media-induced adverse reactions (AR). This study investigated the risk factors of ARs to nonionic iodinated contrast media. Methods: This study evaluated patients who were administered iodinated contrast media during CT scanning in Yeouido St. Mary's Hospital in Seoul, Korea in 2012. Among the subjects, those with contrast media-induced ARs were classified as the AR group. The control group included individuals without ARs who were selected through simple random sampling. The effects of sex, age, contrast media type and dose, CT region, previous contrast media administration, allergy history, and comorbidity were analyzed in the AR and control groups. Results: Multivariate logistic regression analyses were performed to evaluate the identified AR risk factors in 103 subjects in the AR group and 412 subjects in the control group. The results confirmed that the risk of developing ARs was significantly higher in females [odds ratio (OR): 2.206; 95% confidence interval (CI): 1.353- 3.598], in individuals administered Iohexol (OR: 9.981; 95% CI: 2.361-42.193), in individuals with an allergy history (OR: 3.982; 95% CI: 1.742-9.101), and in individuals with comorbid asthma (OR: 6.619; 95% CI: 1.377-31.826). Most of the ARs were mild and immediate. Conclusion: In patients who were administered contrast media during CT scans, female gender, Iohexol use, allergy history, and asthma were risk factors for ARs. Therefore, special care is required for patients with such risk factors to prevent ARs.
참고문헌 (18)
- Ono K, "Estimation of the number of CT procedures based on a nationwide survey in Japan", Health Phys, 100, pp.491~496 (2011)
- Berrington de Gonzalez A, "Projected cancer risks from computed tomographic scans performed in the United States in 2007", Arch Intern Med, 169, pp.2071~2077 (2009)
- Christiansen C, "X-ray contrast media--an overview", Toxicology, 209, pp.185~187 (2005)
- Gomi T, "Are there any differences in acute adverse reactions among five low-osmolar non-ionic iodinated contrast media?", Eur Radiol, 20, pp.1631~1635 (2010)
- Katayama H, "Adverse reactions to ionic and nonionic contrast media. A report from the Japanese Committee on the Safety of Contrast Media", Radiology, 175, pp.621~628 (1990)
- Sutton AG, "Early and late reactions after the use of iopamidol 340, ioxaglate 320, and iodixanol 320 in cardiac catheterization", Am Heart J, 141, pp.677~683 (2001)
- Lasser EC, "Reports on contrast media reactions:analysis of data from reports to the U.S. Food and Drug Administration", Radiology, 203, pp.605~610 (1997)
- Mortele KJ, "Universal use of nonionic iodinated contrast medium for CT: evaluation of safety in a large urban teaching hospital", AJR Am J Roentgenol, 184, pp.31~34 (2005)
- Bush WH, "Acute reactions to intravascular contrast media: types, risk factors, recognition, and specific treatment", AJR Am J Roentgenol, 157, pp.1153~1161 (1991)
- Brockow K, "Classification and pathophysiology of radiocontrast media hypersensitivity", Chem Immunol Allergy, 95, pp.157~169 (2010)
- Kobayashi D, "Risk factors for adverse reactions from contrast agents for computed tomography", BMC Med Inform Decis Mak, 13, pp.18~ (2013)
- Bottinor W, "Adverse reactions to iodinated contrast media", Int J Angiol, 22, pp.149~154 (2013)
- Traub SJ, "Risk factors for radiocontrast nephropathy after emergency department contrast-enhanced computerized tomography", Acad Emerg Med, 20, pp.40~45 (2013)
- Zhang BC, "Post-marketing surveillance study with iodixanol in 20 185 Chinese patients from routine clinical practices", Br J Radiol, 87, pp.20130325~ (2014)
- "ACR manual on contrast media, version 9" (2013)[URL]
- Solomon R, "The role of osmolality in the incidence of contrast-induced nephropathy: a systematic review of angiographic contrast media in high risk patients", Kidney Int, 68, pp.2256~2263 (2005)
- Wendt-Nordahl G, "Intravenous contrast media in uroradiology: evaluation of safety and tolerability in almost 50,000patients", Med Princ Pract, 15, pp.358~361 (2006)
- Kyung Eun Jung, "A Clinical Study of Cutaneous Adverse Reactions to Nonionic Contrast Media in Korea", Annals of Dermatology, 24(1), pp.22~25 (2012), 대한피부과학회
