J Korean Soc Radiol.  2019 Mar;80(2):294-305. 10.3348/jksr.2019.80.2.294.

Clinical Manifestations of Contrast Media Extravasation in the Emergency Department and the Ward

• Bae JG
• Kang TK
• Ryu S
• Cho SJ
• Oh SC
• Kim HJ
• Choi SW
• Lee SH
• Kang MJ

• KMID: 2442520
• DOI: http://doi.org/10.3348/jksr.2019.80.2.294

Abstract

PURPOSE
Contrast media extravasation (CME) is an adverse reaction after administration of contrast media during CT examinations. The purpose of this study was to evaluate the frequency, management, and outcomes of extravasations and to assess the risk factors for CME in the emergency department (ED) and the ward.
MATERIALS AND METHODS
This retrospective study was conducted at a single academic urban hospital from January 2013 to December 2015. We analyzed the medical records of all patients who experienced CME after undergoing a CT scan. We compared the patients' age, sex, underlying disease, injection site, injection flow rate, time of CT examination, type of CT examination, and severity of injury between those in the ED and the ward.
RESULTS
CME occurred in 41 (0.36%) of 114767 patients, which included 16 (0.34%) in the ED and 25 (0.37%) in the ward. Both groups were more frequent in those aged older than 60 years and in female. Additionally, the abdominopelvic CT type and 2-3 mL/s as the injection rate were more common in both groups. However, CME was more frequent during the nighttime (10, 62.5%) in the ER, while it was more common in the daytime (14, 56.0%) in the ward. Severe complications were more frequent in the ER (9, 56.3%) compared with the ward (8, 32.8%). There were no significant differences in CME between the ED and the ward. When comparing the clinical manifestations in the mild and severe groups, the antecubital fossa (33.3% and 0%, respectively; p = 0.013) for the injection site and abdominopelvic CT (41.7% and 82.4%, respectively; p = 0.012) and CT angiography (41.7% and 5.87%, respectively; p = 0.014) for the CT examination showed significant differences between the mild and severe groups.
CONCLUSION
In this study, there were no significant clinical differences in CME between the ED and ward. Thus, prevention is more important than the place of admission. Radiologists and emergency physicians should pay attention to CME in the ED because it frequently occurs at night and results in more severe complications.

MeSH Terms

Angiography
Contrast Media*
Emergencies*
Emergency Service, Hospital*
Extravasation of Diagnostic and Therapeutic Materials*
Female
Hospitals, Urban
Humans
Medical Records
Retrospective Studies
Risk Factors
Tomography, X-Ray Computed
Contrast Media

Reference

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