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

  • Contrast Media
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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.

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Abbreviations

CI:

Confidence interval

CM:

Contrast media

EEV:

Estimated extravasated volume

ICU:

Intensive care unit

OR:

Odds ratio

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Acknowledgement

The statistical analyses in the present study were supported by the Medical Research Collaborating Center in Seoul National University Hospital. We would also like to thank Chris Woo for editing this manuscript.

Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea

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

  2. Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea

    Chang Min Park

Authors
  1. Eui Jin Hwang
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  2. Cheong-Il Shin
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  3. Young Hun Choi
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  4. Chang Min Park
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Corresponding author

Correspondence to Chang Min Park.

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Guarantor

The scientific guarantor of this publication is Chang Min Park.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

The requirement for written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• observational

• performed at one institution

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Hwang, E.J., Shin, CI., Choi, Y.H. et al. Frequency, outcome, and risk factors of contrast media extravasation in 142,651 intravenous contrast-enhanced CT scans. Eur Radiol 28, 5368–5375 (2018). https://doi.org/10.1007/s00330-018-5507-y

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  • DOI: https://doi.org/10.1007/s00330-018-5507-y

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