title: Extravasation of contrast medium during CT examination: an observational case-control study.
abstract: BACKGROUND
  Extravasation is an adverse reaction to intravenous injection of contrast medium (CM) during CT examination. The objectives of this study are to determine the frequency, management and outcomes of extravasations and to assess risk factors for extravasation.
  
  
  METHODS
  Every incident of extravasation which occurred between March 2012 and March 31, 2013 was recorded in an extravasation form. Ethics Committee approval was obtained and the patients gave their consent to participate in the study. Data collected in the form included patients' age, sex, comorbidities, symptoms, CM used, injection mode, site and rate, extravasated volume, location of extravasation, severity of injury, treatment and patient outcome. Each case was matched with 4 controls of the same age ± 5 years and the same gender when possible.
  
  
  RESULTS
  Extravasation occurred in 18 (7 women, 11 men) out of 2,000 injections of CM (0.9%) with a median age of 53 (10-78) years. Automated injection was performed in all cases with a mean rate of 1.7 ml/s. Large extravasated volumes (≥50 ml) were more observed in patients undergoing CT angiography (28.6% vs. 6.6%, although not significant P=0.112). Multivariate analysis revealed a significant association between patients with cardiac diseases and extravasation (OR: 7.3, 95% CI (1.09-49.05), P=0.04) whereas the injection rate is a protective factor from extravasation (P=0.002).
  
  
  CONCLUSIONS
  Extravasation of CM results in mild to moderate adverse effects in all cases. Our study suggests that patients with cardiac disease are more predisposed to contrast extravasation than others. Further and larger studies are needed to confirm this trend.
authors.affiliation: Pharmacovigilance Unit, Mohamed VI University Hospital, Department of Pharmacology, Medical and Pharmacy School, University Mohammed the First, Oujda, Morocco.
authors.forename: Zayneb
authors.initials: Z
authors.lastname: Alami
authors.affiliation: Department of Radiology, Mohamed VI University Hospital, Medical and Pharmacy School, University Mohammed the First, Oujda, Morocco.
authors.forename: Siham
authors.initials: S
authors.lastname: Nasri
authors.affiliation: Pharmacoepidemiology and Pharmacoeconomics Research Team. Mohammed V Rabat University, Morocco.
authors.forename: Samir
authors.initials: S
authors.lastname: Ahid
authors.affiliation: Department of Radiology, Mohamed VI University Hospital, Medical and Pharmacy School, University Mohammed the First, Oujda, Morocco.
authors.forename: Hanane Hadj
authors.initials: HH
authors.lastname: Kacem
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000792:Angiography / Q000009:adverse effects / Q000379:methods; D016022:Case-Control Studies; D002648:Child; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000009:adverse effects* / Q000379:methods; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: Extravasation; computed tomography (CT); contrast media/medium; risk factors