Division of General Internal Medicine, Department of Medicine, St. Luke's International Hospital, Tokyo, Japan.
BMC Med Inform Decis Mak. 2013 Jan 30;13:18. doi: 10.1186/1472-6947-13-18.
Symptoms of an adverse reaction to contrast agents for computed tomography are diverse ranging, and sometimes serious. The goal of this study is to create a scoring rule to predict adverse reactions to contrast agents used in computed tomography.
This was a retrospective cohort study of all adult patients undergoing contrast enhanced CT scan for 7 years. The subjects were randomly divided into either a derivation or validation group. Baseline data and clinically relevant factors were collected from the electronic chart. Primary outcome was any acute adverse reactions to contrast media, observed for during 24 hours after administration. All potential candidate predictors were included in a forward stepwise logistic regression model. Prediction scores were assigned based on β coefficient. A receiver operating characteristic (ROC) curve was drawn, and the area under the curve (AUC) and incidence of acute adverse reactions at each point were obtained. The same process was performed in the validation group.
36,472 patients underwent enhanced CT imaging: 20,000 patients in the derivation group and 16,472 in the validation group. A total of 409 (2.0%, 95% CI:1.9-2.3) and 347 (2.1%, 95% CI:1.9-2.3) acute adverse reactions were seen in the derivation and validation groups. Logistic regression analysis revealed that prior adverse reaction to contrast agents, urticaria, an allergic history to drugs other than contrast agents, contrast agent concentration >70%, age <50 years, and total contrast agent dose >65 g were significant predictors of an acute adverse reaction. AUC was 0.70 (95% CI:0.67-0.73) and 0.67 (95% CI:0.64-0.70) in the derivation and validation groups.
We suggest a prediction model consisting of six predictors for acute adverse reactions to contrast agents used in CT.
CT 造影剂不良反应的症状多种多样，有时甚至很严重。本研究旨在建立一种评分规则，以预测 CT 造影剂的不良反应。
这是一项回顾性队列研究，纳入了 7 年内所有接受增强 CT 扫描的成年患者。将受试者随机分为推导组或验证组。从电子病历中收集基线数据和临床相关因素。主要结局是给药后 24 小时内观察到的任何急性造影剂不良反应。所有潜在的候选预测因子均纳入向前逐步逻辑回归模型。根据β系数分配预测评分。绘制受试者工作特征（ROC）曲线，得出曲线下面积（AUC）和各点的急性不良反应发生率。在验证组中进行相同的过程。
36472 例患者行增强 CT 成像：推导组 20000 例，验证组 16472 例。推导组和验证组分别有 409 例（2.0%，95%CI：1.9-2.3）和 347 例（2.1%，95%CI：1.9-2.3）发生急性不良反应。Logistic 回归分析显示，既往造影剂不良反应、荨麻疹、药物过敏史（非造影剂）、造影剂浓度>70%、年龄<50 岁、总造影剂剂量>65g 是急性不良反应的显著预测因子。推导组和验证组的 AUC 分别为 0.70（95%CI：0.67-0.73）和 0.67（95%CI：0.64-0.70）。
我们提出了一个包含 6 个预测因子的 CT 造影剂急性不良反应预测模型。
