Shehadi W H
Am J Roentgenol Radium Ther Nucl Med. 1975 May;124(1):145-52. doi: 10.2214/ajr.124.1.145.
Case reports on 112,003 patients obtained through a prospective survey have been studied and submitted to computer processing. The significant findings have been reviewed and their importance discussedmthe following points are noteworthy: the value of pretesting is doubtful; and routine pretesting is not a recommended procedure. The constant readiness of a fully equipped emergency tray offers far greater security and assurance of patient safety than the unpredictable and unreliable results of pretesting. The over-all incidence of nonfatal reactions is lower than has been prviously indicated: 5.65 per cent for intravenous urography; and 2.33 per cent for intravascular studies. The incidence of fatal reaction (1 in 10,000) is higher than that reported on the basis of retrospective studies. This figure may or may not be duplicated in the next 100,000 examinations. The cause of death in some patients may be related to a combination of factors-primary disease, diagnostic procedure, and contrast medium. The over-all incidence of adverse reactions in patients with allergy is about twice that in the general population. The incidence of adverse reactions is highest in the third and fourth decades, and lowest at either end of the age spectrum. Incidence of reactions is equal in both sexes. History of reaction to previous examinations is not a contraindication to re-examination. The incidence is approximately 3 times that of the general population. Rapid injection rate, in intravenous urography, is accompanied by fewer reactions than a slow injection rate. A slow injection rate in intravenous cholangiography is accompanied by fewer ractions than a rapid injection rate. It is anticipated that this program will continue, so that additional meaningful data and significant information will be accumulated. The members of our Committee are of the firm belief that this program will become the foundation of a permanent national and international adverse reaction reporting system, thus meeting a great need. We invite the collaboration and support of all those interested and involved in the many phases of contrast medium work.
通过前瞻性调查获得的112,003例患者的病例报告已被研究并提交计算机处理。对重要发现进行了审查并讨论了其重要性，以下几点值得注意：预测试的价值值得怀疑；常规预测试不是推荐的程序。配备齐全的急救托盘随时可用，比预测试不可预测且不可靠的结果能提供更高的安全性和患者安全保障。非致命反应的总体发生率低于先前指出的水平：静脉肾盂造影为5.65%；血管造影研究为2.33%。致命反应的发生率（万分之一）高于基于回顾性研究报告的发生率。这个数字在接下来的10万次检查中可能会重复出现，也可能不会。一些患者的死亡原因可能与多种因素有关——原发性疾病、诊断程序和造影剂。过敏患者不良反应的总体发生率约为普通人群的两倍。不良反应的发生率在第三个和第四个十年最高，在年龄谱的两端最低。两性的反应发生率相等。既往检查有反应史并非再次检查的禁忌症。发生率约为普通人群的3倍。在静脉肾盂造影中，快速注射率比缓慢注射率伴随更少的反应。在静脉胆管造影中，缓慢注射率比快速注射率伴随更少的反应。预计该项目将继续进行，以便积累更多有意义的数据和重要信息。我们委员会的成员坚信，该项目将成为一个永久性的国家和国际不良反应报告系统的基础，从而满足一项重大需求。我们邀请所有对造影剂工作的许多阶段感兴趣并参与其中的人进行合作与支持。
