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Acute Adverse Reactions and Extravasation of Iodinated Contrast Media during Computerized Tomography Scans: A 7‑year Experience in a Local Teaching Hospital
摘要
Purpose: We report on an analysis of the pattern and incidence of acute adverse drug reactions (ADRs) to iodinated contrast media (ICM) that occurred in a regional teaching hospital. Materials and Methods: We analyzed all ADRs that occurred from January 2014 to December 2020 among a cohort of 68,099 patients who underwent contrast‑enhanced computerized tomography (CT) scan examination. The ICM in this study were iohexol (350 mg/mL), iodixanol (320 mg/mL), iopamidol (370 mg/mL), and iobitridol (350 mg/mL). ADRs were classified as mild, moderate, or severe according to criteria issued by the American College of Radiology. Results: Among 68,099 patients who underwent contrast‑enhanced CT scan examination during the study, ADRs occurred in 86 cases (incidence, 0.126%), with 60 mild reactions (incidence: 0.088%), 21 moderate reactions (incidence: 0.031%), and 5 severe reactions (incidence: 0.007%) in the cohort. The observed ADR incidence was 0.120% for iohexol, 0.120% for iopamidol, 0.244% for iodixanol, and 0.230% for iobitridol. A total of 26 patients (21 moderate and 5 severe; 0.038% of all contrast‑enhanced CT examinations) required further management, while the remaining cases resolved spontaneously without any medication. No death from ADRs was recorded during the study. ICM extravasation was encountered in an additional 61 cases (incidence: 0.090%), with three patients (incidence: 0.004%) who had blisters requiring local management with antibiotics and gauze, and one patient (incidence: 0.001%) who had compartment syndrome requiring surgical decompression. Conclusion: ADRs occurred in 0.126% of the study cohort. Those that occurred due to ICM administration were generally mild. The incidence of patients with severe or moderate ADRs requiring further medical management was 0.038%, with ICM extravasation encountered in an additional 0.090% of cases.