Intravenous contrast media: use and associated mortality.
OBJECTIVE
To determine the extent of use and mortality associated with peripheral intravenous injections of radiocontrast media.


METHODS
A retrospective study of injection data was made for the three and a half year period from January 1987 to June 1990 using the Health Insurance Commission database and the records of public hospital x-ray departments. Information about deaths associated with the injections was obtained from a survey of all radiologists and from other relevant sources.


METHODS
The study related to the entire population of New South Wales and the Australian Capital Territory, approximately 6 million people.


METHODS
Intravenous injections of radiographic contrast medium for computed tomographic scans, intravenous pyelograms and venograms.


RESULTS
A comprehensive record of intravenous contrast usage and associated mortality in a large community.


RESULTS
Between January 1987 and June 1990, 613 581 intravenous injections of radiocontrast media were administered in New South Wales and the Australian Capital Territory. The overall annual incidence of use was estimated to be 2.9% and was markedly age dependent being more than 7% in subjects over 65 years. Eight deaths were documented, representing an overall mortality of 13 per million injections (95% confidence interval [CI], 5.6-25.7). Mortality appeared to be age related being 35 per million (95% CI, 12.7-75.6) in those over 65 years compared with 4.5 per million (95% CI, 0.6-16.4) in those under 65 years. Two of the deaths involved low osmolar contrast media.


CONCLUSIONS
Death after injection of intravenous contrast medium is a rare event. There was no evidence that mortality was lower with the newer, low osmolar media than with the older, high osmolar media.
Cashman
J D
JD
Royal North Shore Hospital, St Leonards, NSW.
McCredie
J
J
Henry
D A
DA
D016907:Adverse Drug Reaction Reporting Systems; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000401:mortality*; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D015876:Northern Territory; D009994:Osmolar Concentration; D010690:Phlebography; D011331:Private Practice; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014567:Urography
D003287:Contrast Media