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European Radiology
Published in: European Radiology 12/2018

01-12-2018 | Contrast Media

Frequency, outcome, and risk factors of contrast media extravasation in 142,651 intravenous contrast-enhanced CT scans

Authors: Eui Jin Hwang, Cheong-Il Shin, Young Hun Choi, Chang Min Park

Published in: European Radiology | Issue 12/2018

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Abstract

Objective

To evaluate the frequency, outcome, and risk factors of intravenous contrast media (CM) extravasation during contrast-enhanced CT scans in a large population.

Methods

After institutional review board approval, 142,651 patients (72,976 males and 69,675 females; mean age, 59.9 ± 13.0 years) who underwent contrast-enhanced CT scans with intravenous CM between January 2015 and April 2017 were retrospectively included. The frequency of CM extravasations and their clinical outcomes were investigated. Risk factors of CM extravasation were evaluated using logistic regression with generalized estimating equation analyses. In addition, the frequency and risk factors of large-volume (≥100 ml) CM extravasation were also investigated.

Results

CM extravasation occurred in 0.23% (321/142,651) of patients, all of which were of mild degree and resolved without any sequelae through conservative management. Multivariate analysis revealed that female gender [odds ratio (OR) = 1.61; p < 0.001], 60 < age ≤ 70 years (OR = 1.71; p = 0.004) or age > 70 years (OR = 2.49; p < 0.001), patients in general wards (OR = 2.71; p < 0.001) or ICUs (OR = 4.76; p < 0.001), 9.4 < CM viscosity ≤ 10.0 (OR = 1.65; p = 0.015), 10.0 < CM viscosity ≤ 10.6 (OR = 1.60; p = 0.002), and CM viscosity > 16.0 (OR = 2.55, p < 0.001) were independent risk factors for CM extravasation.

Conclusion

CM extravasation during contrast-enhanced CT scans was uncommon with no substantial clinical consequences. Several risk factors that may have the potential to reduce the occurrence of CM extravasation were identified.

Key Points

• The observed frequency of contrast media extravasation during contrast-enhanced CT scans was 0.23% (321/142,651).
• Significant risk factors for contrast media extravasation were female gender, age older than 60 years, patients in general wards or ICUs, and the viscosity of contrast media greater than 9.4 mPa∙s.
• The main preventive action for contrast media extravasation would be to lower the viscosity of contrast media.
Appendix
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Metadata
Title
Frequency, outcome, and risk factors of contrast media extravasation in 142,651 intravenous contrast-enhanced CT scans
Authors
Eui Jin Hwang
Cheong-Il Shin
Young Hun Choi
Chang Min Park
Publication date
01-12-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5507-y

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