Hopper K D, Matthews Y L
Department of Radiology, Pennsylvania State University, Hershey 17033.
Invest Radiol. 1993 Apr;28(4):303-7. doi: 10.1097/00004424-199304000-00008.
Because of the greatly increased cost of nonionic, low-osmolar contrast material, some practitioners reserve its use for patients at high risk for an adverse contrast reaction. The authors attempt to evaluate the proportion of low-risk outpatients--when offered a choice between the more expensive but lower-risk nonionic and the cheaper but higher-risk conventional ionic contrast material--that would choose the nonionic media.
Two hundred and fifty consecutive outpatients awaiting contrast-enhanced computed tomography were included in this study. Patients at increased risk for a contrast reaction were excluded. The remaining 162 patients were informed of the risks and told of the availability of nonionic contrast media with its up to six-fold decrease in serious complications. They were also informed that if they chose the lower-risk nonionic agent, they would likely have to pay the additional $100 to $150 in cost.
Of the 162 low-risk patients surveyed, 48% selected nonionic contrast media, and 63% believed that all patients should be informed of the risks of contrast material and of the availability of nonionic contrast.
The data support providing patients at low risk for an adverse reaction informed consent about the relative risks of ionic and nonionic contrast material.
由于非离子型低渗造影剂成本大幅增加，一些从业者仅将其用于发生造影剂不良反应高风险的患者。作者试图评估低风险门诊患者在面对更昂贵但风险较低的非离子型造影剂与更便宜但风险较高的传统离子型造影剂之间进行选择时，会选择非离子型造影剂的比例。
本研究纳入了连续250名等待增强CT检查的门诊患者。排除了造影剂不良反应风险增加的患者。其余162名患者被告知风险，并得知有非离子型造影剂可供使用，其严重并发症发生率可降低多达六倍。他们还被告知，如果选择风险较低的非离子型造影剂，可能需要额外支付100至150美元。
在接受调查的162名低风险患者中，48%选择了非离子型造影剂，63%认为应告知所有患者造影剂的风险以及非离子型造影剂的可用性。
数据支持向不良反应低风险患者提供关于离子型和非离子型造影剂相对风险的知情同意。
