title: Utility of the creatinine prior to intravenous contrast studies in the emergency department.
abstract: The purpose of this study was to determine if it is possible to identify patients who have underlying renal insufficiency by evaluating their risk factors prior to receiving intravenous contrast in the emergency department (ED). This would allow selective ordering of a creatinine, resulting in a cost and time savings. This prospective study involved 640 consecutive adult patients presenting to the ED with a clinical indication for an intravenous contrast study. Physicians completed a study form evaluating a patient's risk factors for renal insufficiency. A serum creatinine was then obtained on all patients with a level of 1.6 mg/dl or greater considered abnormal. Thirty-five (5.5%) had an abnormal creatinine. Of these 35 patients, 27 (4.2%) had identifiable risk factors for renal insufficiency. Eight (1.3%) had no identifiable risk factors for renal insufficiency. In conclusion, it is possible to identify approximately 99% of ED patients at risk for contrast induced nephropathy by evaluation of risk factors.
authors.affiliation: Department of Emergency Medicine, Lutheran General Hospital, Park Ridge, Illinois 60068, USA.
authors.forename: J C
authors.initials: JC
authors.lastname: Olsen
authors.forename: B
authors.initials: B
authors.lastname: Salomon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000009:adverse effects; D003404:Creatinine / Q000097:blood*; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D051437:Renal Insufficiency / Q000097:blood* / Q000139:chemically induced / Q000517:prevention & control
chemical_list: D003287:Contrast Media; D003404:Creatinine