title: How accurate is the label "allergic to iodinated contrast agents"?
abstract: BACKGROUND
  Iodinated contrast agents (ICAs) are crucial to the use of many imaging studies. Reported allergies to ICAs in the medical record can interfere with optimal diagnostic imaging workups.
  
  
  OBJECTIVE
  To investigate the accuracy with which the label "allergic to ICAs" is applied.
  
  
  METHODS
  The medical records of 500 patients labeled "allergic to ICAs" at a single tertiary care hospital were reviewed. Patients were separated into three groups based on documentation in their medical records, as follows: Group 1, documented hypersensitivity reaction to ICAs; Group 2, documented ICA exposure with non-hypersensitivity adverse event (Group 2a) or without documented reaction (Group 2b); and Group 3, no documented prior exposure to an ICA. We then further reviewed the EMR to determine whether or not patients had subsequent administration of an ICA, whether or not they were given specific premedication, and whether or not they had a subsequent ICA-related event.
  
  
  RESULTS
  A total of 16.6% of patients (n = 83) listed as "allergic to ICAs" had a documented hypersensitivity reaction following ICA administration (Group 1) while 58.6% (n = 293) of patients (Group 2) had a documented exposure to ICAs with either: (i) a non-hypersensitivity adverse event (23.5%, n = 69) or (ii) no record of a reaction to ICAs (76.5%, n = 224). The remaining 24.8% (n = 124), Group 3, had no record of exposure to an ICA, yet still carried the label.
  
  
  CONCLUSIONS
  The majority of patients carrying the label "allergic to ICAs" had no record of a prior hypersensitivity reaction to ICAs.
authors.affiliation: Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA Duke University Hospital, Durham, North Carolina, USA joseph.mammarappallil@duke.edu.
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Mammarappallil
authors.affiliation: Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA.
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Hiatt
authors.affiliation: Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA.
authors.forename: William
authors.initials: W
authors.lastname: Vincent
authors.affiliation: Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Bettmann
mesh_terms: D003287:Contrast Media / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000453:epidemiology*; D057286:Electronic Health Records; D006801:Humans; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers
chemical_list: D003287:Contrast Media
keywords: Computed tomography (CT); QA/QC; contrast agents – intravenous