Patient choice and nonionic contrast media.
OBJECTIVE
Because of the greatly increased cost of nonionic, low-osmolar contrast material, some practitioners reserve its use for patients at high risk for an adverse contrast reaction. The authors attempt to evaluate the proportion of low-risk outpatients--when offered a choice between the more expensive but lower-risk nonionic and the cheaper but higher-risk conventional ionic contrast material--that would choose the nonionic media.


METHODS
Two hundred and fifty consecutive outpatients awaiting contrast-enhanced computed tomography were included in this study. Patients at increased risk for a contrast reaction were excluded. The remaining 162 patients were informed of the risks and told of the availability of nonionic contrast media with its up to six-fold decrease in serious complications. They were also informed that if they chose the lower-risk nonionic agent, they would likely have to pay the additional $100 to $150 in cost.


RESULTS
Of the 162 low-risk patients surveyed, 48% selected nonionic contrast media, and 63% believed that all patients should be informed of the risks of contrast material and of the availability of nonionic contrast.


CONCLUSIONS
The data support providing patients at low risk for an adverse reaction informed consent about the relative risks of ionic and nonionic contrast material.
Hopper
K D
KD
Department of Radiology, Pennsylvania State University, Hershey 17033.
Matthews
Y L
YL
D003287:Contrast Media / Q000009:adverse effects / Q000191:economics*; D003365:Costs and Cost Analysis; D005260:Female; D005382:Financing, Personal; D006801:Humans; D007258:Informed Consent; D007349:Insurance, Health, Reimbursement; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D010358:Patient Participation; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000191:economics*
D003287:Contrast Media