Ke Liu, Xin Cheng, Yongli Zhu, Jun Long, Changsheng Li, Lijun Cui, Kang Li, Changping Mu
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The primary outcome measures were risk factors associated with ICM-AARs. The studies were analyzed for heterogeneity using the <i>Q</i>-test and I<sup>2</sup> statistic, while publication bias was assessed using funnel plots, Egger's test, and Begg's test. Stata 17 software was used for the meta-analysis.</p><p><strong>Results: </strong>Seventeen studies were included, encompassing 2,576,446 CT-enhanced examinations. Of these, 11,621 acute adverse reactions were reported, with a mean incidence of 0.45% and a quality score of ≥7. The meta-analysis showed that female sex (OR = 1.27, 95% CI = 1.13, 1.41), age <35 years (OR = 1.77, 95% CI = 1.19, 2.64), high body mass index (OR = 1.06, 95% CI = 1.01, 1.10), type of medical visit (outpatient) (OR = 2.23, 95% CI = 1.01, 4.93), history of adverse ICM reactions (OR = 11.03, 95% CI = 2.25, 53.97), history of other allergies (OR = 3.16, 95% CI = 1.27, 7.84), history of asthma (OR = 1.75, 95% CI = 1.19, 2.57), hyperthyroldism (OR = 4.59, 95% CI = 1.65, 12.82), and type of ICM (OR = 2.27, 95% CI = 1.68, 3.06) were risk factors for ICM-AARs. Age >60 years (OR = 0.71, 95% CI = 0.53, 0.95), pre-injection medication (OR = 0.56, 95% CI = 0.39, 0.79), and hypertensive disorders (OR = 0.78, 95% CI = 0.65, 0.94) were identified as protective against ICM-AARs.</p><p><strong>Conclusions: </strong>The incidence of ICM-AARs is influenced by a variety of clinical and demographic factors. Healthcare professionals may benefit from dynamically assessing patient-specific risk factors and considering targeted preventive measures for high-risk groups, particularly in populations similar to those studied.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/, PROSPERO (CRD42024571470).</p>","PeriodicalId":73101,"journal":{"name":"Frontiers in radiology","volume":"5 ","pages":"1656949"},"PeriodicalIF":2.3000,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491283/pdf/","citationCount":"0","resultStr":"{\"title\":\"Predictors of acute adverse reactions to non-ionic iodinated contrast media in CT imaging: a systematic review and meta-analysis.\",\"authors\":\"Ke Liu, Xin Cheng, Yongli Zhu, Jun Long, Changsheng Li, Lijun Cui, Kang Li, Changping Mu\",\"doi\":\"10.3389/fradi.2025.1656949\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Iodinated contrast media-acute adverse reactions (ICM-AARs) are frequent and clinically significant complications associated with radiological imaging. Despite investigation of their risk factors, there is no consensus, and no comprehensive synthesis has been conducted. This systematic review and meta-analysis aimed to investigate the factors influencing ICM-AARs.</p><p><strong>Methods: </strong>A systematic search for studies published in Chinese or English up to 22 July 2024 in the PubMed, Web of Science, Cochrane Library, Embase, CNKI, WanFang, CQVIP, and SinoMed databases was conducted. Studies on patients undergolng contrast-enhanced CT examinations with nonionic ICM were selected. The primary outcome measures were risk factors associated with ICM-AARs. The studies were analyzed for heterogeneity using the <i>Q</i>-test and I<sup>2</sup> statistic, while publication bias was assessed using funnel plots, Egger's test, and Begg's test. Stata 17 software was used for the meta-analysis.</p><p><strong>Results: </strong>Seventeen studies were included, encompassing 2,576,446 CT-enhanced examinations. Of these, 11,621 acute adverse reactions were reported, with a mean incidence of 0.45% and a quality score of ≥7. The meta-analysis showed that female sex (OR = 1.27, 95% CI = 1.13, 1.41), age <35 years (OR = 1.77, 95% CI = 1.19, 2.64), high body mass index (OR = 1.06, 95% CI = 1.01, 1.10), type of medical visit (outpatient) (OR = 2.23, 95% CI = 1.01, 4.93), history of adverse ICM reactions (OR = 11.03, 95% CI = 2.25, 53.97), history of other allergies (OR = 3.16, 95% CI = 1.27, 7.84), history of asthma (OR = 1.75, 95% CI = 1.19, 2.57), hyperthyroldism (OR = 4.59, 95% CI = 1.65, 12.82), and type of ICM (OR = 2.27, 95% CI = 1.68, 3.06) were risk factors for ICM-AARs. Age >60 years (OR = 0.71, 95% CI = 0.53, 0.95), pre-injection medication (OR = 0.56, 95% CI = 0.39, 0.79), and hypertensive disorders (OR = 0.78, 95% CI = 0.65, 0.94) were identified as protective against ICM-AARs.</p><p><strong>Conclusions: </strong>The incidence of ICM-AARs is influenced by a variety of clinical and demographic factors. Healthcare professionals may benefit from dynamically assessing patient-specific risk factors and considering targeted preventive measures for high-risk groups, particularly in populations similar to those studied.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/, PROSPERO (CRD42024571470).</p>\",\"PeriodicalId\":73101,\"journal\":{\"name\":\"Frontiers in radiology\",\"volume\":\"5 \",\"pages\":\"1656949\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-09-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491283/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in radiology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3389/fradi.2025.1656949\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in radiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3389/fradi.2025.1656949","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景：碘造影剂急性不良反应（ICM-AARs）是与放射影像学相关的常见且临床显著的并发症。尽管对其危险因素进行了调查，但没有达成共识，也没有进行全面的综合。本系统综述和荟萃分析旨在探讨影响ICM-AARs的因素。方法：系统检索PubMed、Web of Science、Cochrane Library、Embase、CNKI、万方、CQVIP和中国医学信息数据库中截至2024年7月22日发表的中文或英文论文。选择非离子ICM造影增强CT检查患者的研究。主要结局指标是与ICM-AARs相关的危险因素。使用q检验和I2统计量分析研究的异质性，使用漏斗图、Egger检验和Begg检验评估发表偏倚。meta分析采用Stata 17软件。结果：纳入17项研究，包括2,576,446次ct增强检查。其中，急性不良反应报告11,621例，平均发生率为0.45%，质量评分≥7。荟萃分析显示，女性（OR = 1.27, 95% CI = 1.13, 1.41）、年龄60岁（OR = 0.71, 95% CI = 0.53, 0.95）、注射前用药（OR = 0.56, 95% CI = 0.39, 0.79）和高血压疾病（OR = 0.78, 95% CI = 0.65, 0.94）被确定为ICM-AARs的保护因素。结论：ICM-AARs的发生率受多种临床和人口因素的影响。医疗保健专业人员可能受益于动态评估患者特定的风险因素，并考虑针对高危人群，特别是与研究对象相似的人群采取有针对性的预防措施。系统评价注册：https://www.crd.york.ac.uk/PROSPERO/, PROSPERO （CRD42024571470）。
Predictors of acute adverse reactions to non-ionic iodinated contrast media in CT imaging: a systematic review and meta-analysis.
Background: Iodinated contrast media-acute adverse reactions (ICM-AARs) are frequent and clinically significant complications associated with radiological imaging. Despite investigation of their risk factors, there is no consensus, and no comprehensive synthesis has been conducted. This systematic review and meta-analysis aimed to investigate the factors influencing ICM-AARs.
Methods: A systematic search for studies published in Chinese or English up to 22 July 2024 in the PubMed, Web of Science, Cochrane Library, Embase, CNKI, WanFang, CQVIP, and SinoMed databases was conducted. Studies on patients undergolng contrast-enhanced CT examinations with nonionic ICM were selected. The primary outcome measures were risk factors associated with ICM-AARs. The studies were analyzed for heterogeneity using the Q-test and I2 statistic, while publication bias was assessed using funnel plots, Egger's test, and Begg's test. Stata 17 software was used for the meta-analysis.
Results: Seventeen studies were included, encompassing 2,576,446 CT-enhanced examinations. Of these, 11,621 acute adverse reactions were reported, with a mean incidence of 0.45% and a quality score of ≥7. The meta-analysis showed that female sex (OR = 1.27, 95% CI = 1.13, 1.41), age <35 years (OR = 1.77, 95% CI = 1.19, 2.64), high body mass index (OR = 1.06, 95% CI = 1.01, 1.10), type of medical visit (outpatient) (OR = 2.23, 95% CI = 1.01, 4.93), history of adverse ICM reactions (OR = 11.03, 95% CI = 2.25, 53.97), history of other allergies (OR = 3.16, 95% CI = 1.27, 7.84), history of asthma (OR = 1.75, 95% CI = 1.19, 2.57), hyperthyroldism (OR = 4.59, 95% CI = 1.65, 12.82), and type of ICM (OR = 2.27, 95% CI = 1.68, 3.06) were risk factors for ICM-AARs. Age >60 years (OR = 0.71, 95% CI = 0.53, 0.95), pre-injection medication (OR = 0.56, 95% CI = 0.39, 0.79), and hypertensive disorders (OR = 0.78, 95% CI = 0.65, 0.94) were identified as protective against ICM-AARs.
Conclusions: The incidence of ICM-AARs is influenced by a variety of clinical and demographic factors. Healthcare professionals may benefit from dynamically assessing patient-specific risk factors and considering targeted preventive measures for high-risk groups, particularly in populations similar to those studied.
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