title: Intravenous contrast extravasation during CT: a national data registry and practice quality improvement initiative.
abstract: OBJECTIVE
  Establish 3 performance benchmarks for intravenous contrast extravasation during CT examinations: extravasation frequency, distribution of extravasation volumes, and severity of injury. Evaluate the effectiveness of implementing practice quality improvement (PQI) methodology in improving performance for these 3 benchmarks.
  
  
  METHODS
  The Society of Abdominal Radiology and ACR developed a registry collecting data for contrast extravasation events. The project includes a PQI initiative allowing for process improvement.
  
  
  RESULTS
  As of December 2013, a total of 58 radiology practices have participated in this project, and 32 practices have completed the 2-cycle PQI. There were a total of 454,497 contrast-enhanced CT exams and 1,085 extravasation events. The average extravasation rate is 0.24%. The median extravasation rate is 0.21%. Most extravasations (82.9%) were between 10 mL and 99 mL. The majority of injuries, 94.6%, are mild in severity, with 4.7% having moderate and 0.8% having severe injuries. Data from practices that completed the PQI process showed a change in the average extravasation rate from 0.28% in the first 6 months to 0.23% in the second 6 months, and the median extravasation rate dropped from 0.25% to 0.16%, neither statistically significant. The distribution of extravasation volumes and the severity of injury did not change between the first and second measurement periods.
  
  
  CONCLUSIONS
  National performance benchmarks for contrast extravasation rate, distribution of volumes of extravasate, and distribution of severity of injury are established through this multi-institutional practice registry. The application of PQI failed to have a statistically significant positive impact on any of the 3 benchmarks.
authors.affiliation: Department of Radiology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania. Electronic address: tdykes@hmc.psu.edu.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Dykes
authors.affiliation: ACR, Reston, Virginia.
authors.forename: Mythreyi
authors.initials: M
authors.lastname: Bhargavan-Chatfield
authors.affiliation: Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
authors.forename: Raymond B
authors.initials: RB
authors.lastname: Dyer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D015995:Prevalence; D058996:Quality Improvement / Q000592:standards / Q000706:statistics & numerical data; D011871:Radiology / Q000592:standards; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000592:standards* / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: CT; Contrast extravasation; National Radiology Data Registry; practice quality improvement