BMC Med Inform Decis Mak - Risk factors for adverse reactions from contrast agents for computed tomography.


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CKGROUND: Symptoms of an adverse reaction to contrast agents for computed tomography are diverse ranging, and sometimes serious. The goal of this study is to create a scoring rule to predict adverse reactions to contrast agents used in computed tomography.METHODS: This was a retrospective cohort study of all adult patients undergoing contrast enhanced CT scan for 7years. The subjects were randomly divided into either a derivation or validation group. Baseline data and clinically relevant factors were collected from the electronic chart. Primary outcome was any acute adverse reactions to contrast media, observed for during 24hours after administration. All potential candidate predictors were included in a forward stepwise logistic regression model. Prediction scores were assigned based on ? coefficient. A receiver operating characteristic (ROC) curve was drawn, and the area under the curve (AUC) and incidence of acute adverse reactions at each point were obtained. The same process was performed in the validation group.RESULTS: 36,472 patients underwent enhanced CT imaging: 20,000 patients in the derivation group and 16,472 in the validation group. A total of 409 (2.0%, 95% CI:1.9-2.3) and 347 (2.1%, 95% CI:1.9-2.3) acute adverse reactions were seen in the derivation and validation groups. Logistic regression analysis revealed that prior adverse reaction to contrast agents, urticaria, an allergic history to drugs other than contrast agents, contrast agent concentration >70%, age <50years, and total contrast agent dose >65g were significant predictors of an acute adverse reaction. AUC was 0.70 (95% CI:0.67-0.73) and 0.67 (95% CI:0.64-0.70) in the derivation and validation groups.CONCLUSIONS: We suggest a prediction model consisting of six predictors for acute adverse reactions to contrast agents used in CT.

Resumo Limpo

ckground symptom advers reaction contrast agent comput tomographi divers rang sometim serious goal studi creat score rule predict advers reaction contrast agent use comput tomographymethod retrospect cohort studi adult patient undergo contrast enhanc ct scan year subject random divid either deriv valid group baselin data clinic relev factor collect electron chart primari outcom acut advers reaction contrast media observ hour administr potenti candid predictor includ forward stepwis logist regress model predict score assign base coeffici receiv oper characterist roc curv drawn area curv auc incid acut advers reaction point obtain process perform valid groupresult patient underw enhanc ct imag patient deriv group valid group total ci ci acut advers reaction seen deriv valid group logist regress analysi reveal prior advers reaction contrast agent urticaria allerg histori drug contrast agent contrast agent concentr age year total contrast agent dose g signific predictor acut advers reaction auc ci ci deriv valid groupsconclus suggest predict model consist six predictor acut advers reaction contrast agent use ct

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