Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Korea.
Postgrad Med J. 2015 Apr;91(1074):193-9. doi: 10.1136/postgradmedj-2013-132538. Epub 2015 Mar 3.
To evaluate the impact of an electronic consultation support system on the incidence of hypersensitivity reactions to iodinated radiocontrast media (RCM).
A retrospective observational study was conducted before and after the introduction of the consultation support system. The 1-year study period was divided into two 6-month periods: before and after 1 December 2012 (baseline and intervention periods, respectively), which was when our consultation support system was introduced. Data from examinations were collected retrospectively from the hospital information centre and problem reporting sheets in the radiology department. The primary outcome was the incidence of RCM reactions before and after the introduction of the consultation support system. Generalised estimating equations were used to account for the correlation between the same patients measured on multiple occasions.
There were 317/20,179 (1.6%) and 186/19,873 (0.9%) hypersensitivity reactions during the baseline and intervention periods, respectively. The consultation support system significantly decreased the odds of the occurrence of a RCM reaction (OR=0.59, 95% CI 0.49 to 0.71, p<0.001) compared with baseline. There was also a twofold increase in the premedication rate after initiation of the consultation support system (OR=2.05, 95% CI 1.16 to 3.65 p=0.01). However, there was no significant difference in the recurrence rate between the periods (OR=0.97, 95% CI 0.58 to 1.65, p<0.93).
The introduction of the consultation support system reduced the incidence of hypersensitivity reactions to RCM and increased the use of premedication in patients with known hypersensitivity to RCM.
评估电子咨询支持系统对碘造影剂（RCM）过敏反应发生率的影响。
采用回顾性观察研究方法，在引入咨询支持系统前后进行。1 年的研究期间分为两个 6 个月的时间段：引入咨询支持系统之前的 12 月 1 日（基线期）和之后（干预期）。从医院信息中心和放射科问题报告表中收集检查数据。主要结局是引入咨询支持系统前后 RCM 反应的发生率。采用广义估计方程来解释同一患者多次测量之间的相关性。
基线期和干预期分别有 317/20179（1.6%）和 186/19873（0.9%）发生 RCM 反应。与基线期相比，咨询支持系统显著降低了 RCM 反应的发生几率（OR=0.59，95%CI 0.49 至 0.71，p<0.001）。此外，咨询支持系统启动后，预用药率也增加了两倍（OR=2.05，95%CI 1.16 至 3.65，p=0.01）。然而，两个时期之间的复发率没有显著差异（OR=0.97，95%CI 0.58 至 1.65，p<0.93）。
引入咨询支持系统降低了 RCM 过敏反应的发生率，并增加了对已知对 RCM 过敏的患者的预用药。
