Factors associated with radiation exposure in patients with  inflammatory bowel disease.
BACKGROUND
Inflammatory bowel disease (IBD) patients undergo multiple radiological evaluations.


OBJECTIVE
To estimate total and abdominal radiation exposure from diagnostic X-ray investigations in IBD patients and the associated risk factors.


METHODS
Patients with Crohn's disease (CD) or ulcerative colitis (UC) treated in the IBD clinic were recruited. Clinical data were extracted from patient files and radiological data were obtained from the central HMO computer data base.


RESULTS
A total of 199 CD and 125 UC patients were included. The mean cumulative estimated doses (CED) for CD and UC were 21.1 19.5 and 15.1 20.4 millisieverts (mSv) respectively (P < 0.001). Twenty-three patients (7.1%) had an estimated CED of > or =50 mSv. In multivariate analyses, predictors of increased CED were: surgery (OR 5.68, 95% CI: 2.73-11.8, P < 0.001), CD (OR 2.56, 95% CI: 1.29-5.07, P = 0.007), prednisone use (OR 2.0, 95% CI: 1.11-3.67, P = 0.02), first year of disease (OR 6.4, 95% CI: 1.3-32, P = 0.02) and age in the upper quartile(OR 3.26, 95% CI: 1.68-6.3, P = 0.001).


CONCLUSIONS
Diagnosis of CD, IBD-related surgery, prednisone use, first year of diagnosis and age on the upper quartile are independent predictors of increased exposure in IBD patients. Alternative investigations which do not require radiation exposure should be considered for patients at risk for increased radiation exposure.
Levi
Z
Z
Division of Gastroenterology, Rabin Medical Center, Beilinson Hospital, Petah Tikva and University of Tel-Aviv, Israel. zohar_levi@012.net.il
Fraser
E
E
Krongrad
R
R
Hazazi
R
R
benjaminov
O
O
meyerovitch
J
J
Tal
O B
OB
Choen
A
A
Niv
Y
Y
Fraser
G
G
D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D003093:Colitis, Ulcerative / Q000150:complications / Q000000981:diagnostic imaging*; D003424:Crohn Disease / Q000150:complications / Q000000981:diagnostic imaging*; D003952:Diagnostic Imaging / Q000009:adverse effects*; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D008297:Male; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D011832:Radiation Injuries / Q000453:epidemiology / Q000209:etiology*; D011859:Radiography; D012307:Risk Factors