1991 Fiscal Year Final Research Report Summary
Research on Risk Factors of Adverse Reactions to Iodinated Contrast Media
| Project/Area Number |
01480276
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| Research Category |
Grant-in-Aid for General Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
Radiation science
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| Research Institution | Juntendo University School of Medicine |
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Principal Investigator |
KATAYAMA Hitoshi. Juntendo University. Department of Radiology. Professor, 医学部, 教授 (80053007)
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| Co-Investigator(Kenkyū-buntansha) |
KUWATSURU Ryohei Juntendo University. Department of Radiology. Assistant Professor, 医学部, 助手
SUMI Yukiharu. Juntendo University. Department of Radiology. Associate Professor, 医学部, 助教授 (40171300)
TOMITA Takashi. Juntendo University. Department of Radiology. Lecturer, 医学部, 講師 (20188783)
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| Project Period (FY) |
1989 – 1991
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| Keywords | contrast media / adverse reaction / risk factor |
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| Research Abstract |
Comparative studies of adverse reactions (ADR) to ionic and nonionic iodinated contrast media was performed using a large scale of survey from multi-institutional sources. The studies were restricted to examinations with intravenous application of contrast media A total of 352, 817 cases were collected. The pevalence of all ADRs were 12.66% for ionic and 3.13% for nonionic contrast media examinations. Severe ADRs occurred in 0.22% of ionic and 0.04% of nonionic contrast media examinations. About 70% of ADRs due to either ionic or nonionic contrast media occurred during or within 5 minuts of injection. As far as severe ADRs concerned, prevalence of ADRs were highest- : patients with a history of previous ADRS, history of allergy, especially asthma, and cardiac disease.
In order to clarify the risk factors to intravenous administration of iodinated contrast media, meta-analysis of 337, 647 cases was performed by using logistic regression technique. Logistic regression showed that nonionic low osmolar contrast media was 5.6 times safer than conventional ionic high osmolar contrast media. Major risk factors were : history of ADRs at exposure to contrast media (4-7 times), history of asthma (10 times), and underlying cardiac disease (3 times). The incidence of severe ADRs in patients with above three major risk factors was 120 times higher than in patients without. All ADRs were significantly reduced by using nonionic low osmolar contrast media, including life-threatening ADRS : sudden drop of blood pressure (8・3 times), loss of consciousness (7・5 times), cardiac arrest (7-0 times), and dyspnea (4・5 times). Mechanism of ADRs to iodinated contrast media is still indeterminate, and further investigation should be performed. We are much interested immunological approach.
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