An audit of iodinated contrast media allergy of a medical center in Taiwan

Background and Aims: Previous literatures revealed that mild hypersensitivity reactions (e.g. skin rashes, urticaria, nausea etc) to radiologic contrast media incidence was < 3%, ) and moderate to severe (e.g. laryngeal edema, tachycardia or bradycardia, cardiac failure, etc) incidence was < 0.04%). Mortality is less than one death per 100000 patients. The audit report aims to determine the frequency, management, and outcomes of allergy of intravenously injected iodinated contrast medium. Methods: Between 2008 and 2014,a total of 4384 patients in Group A (ionic contrast) (vs. 51654, Group B, non-ionic) received contrast medium examinations (CT and intravenous urography) were analyzed. The incident reports, radiology reports, and medical records of patients in whom contrast medium extravasations occurred were reviewed. Results: There were 134 injections in Group A (ionic, 4384 injections) and 244 injections (non-ionic, 51654 injections) in Group B. Allergic-like reaction rates were 0.68% [n=378]: mild, 2.6% [n=114] and in Group A vs 0.40% [n=207] in Group B; moderate/severe, 0.46% [n=20] and in Group A vs 0.07% [n=37] in Group B. Conclusion: The frequency of allergy decreases with use of non-ionic contrast media. The use of nonionic iodinated contrast medium has lesser in moderate or severe adverse effects than ionic contrast medium.