Abstract：
UNASSIGNED: In collaboration with the Department of Rheumatology, Allergy and Immunology, our study aims to review the outcomes of and propose an improved workflow for the management of patients with prior hypersensitivity reactions to iodinated contrast media (ICM).
UNASSIGNED: Outpatients coming for contrast-enhanced computed tomography (CECT) were stratified into 3 categories (definite, unconfirmed and inaccurate) based on likelihood of their contrast hypersensitivity label. Patients could be offered a different ICM, receive the same ICM, or be referred to an allergist for further evaluation. There were 4 outcomes: (1) alternative ICM tolerated; (2) same ICM tolerated again; (3) patient developed a hypersensitivity reaction to either alternative or original ICM; and (4) CECT was deferred until assessment by an allergist. Comparison was made pre- and post-intervention to see if patient outcomes were improved.
UNASSIGNED: There were 132 patients who made a total of 154 visits (90.3% had documented contrast hypersensitivity). Post-intervention, the number of visits postponed for premedication decreased (81.0% to 34.7%). There was a reduction in hypersensitivity reactions (from 42.9% to 14.3%). Of the 12 patients assessed by the allergist, 6 could continue using the same or alternative ICM, 4 were advised to abstain from further contrast administration and 2 were pending testing with a third agent.
UNASSIGNED: Active intervention by the radiologist can decrease the number of postponed, converted or cancelled CECT studies as well as reduce the number of adverse allergic-like events. Direct collaboration between radiologist and allergist for specific cases may be helpful in patients who will likely need future/repeated CECTs.
UNASSIGNED: Outpatients coming for contrast-enhanced computed tomography (CECT) were stratified into 3 categories (definite, unconfirmed and inaccurate) based on likelihood of their contrast hypersensitivity label. Patients could be offered a different ICM, receive the same ICM, or be referred to an allergist for further evaluation. There were 4 outcomes: (1) alternative ICM tolerated; (2) same ICM tolerated again; (3) patient developed a hypersensitivity reaction to either alternative or original ICM; and (4) CECT was deferred until assessment by an allergist. Comparison was made pre- and post-intervention to see if patient outcomes were improved.
UNASSIGNED: There were 132 patients who made a total of 154 visits (90.3% had documented contrast hypersensitivity). Post-intervention, the number of visits postponed for premedication decreased (81.0% to 34.7%). There was a reduction in hypersensitivity reactions (from 42.9% to 14.3%). Of the 12 patients assessed by the allergist, 6 could continue using the same or alternative ICM, 4 were advised to abstain from further contrast administration and 2 were pending testing with a third agent.
UNASSIGNED: Active intervention by the radiologist can decrease the number of postponed, converted or cancelled CECT studies as well as reduce the number of adverse allergic-like events. Direct collaboration between radiologist and allergist for specific cases may be helpful in patients who will likely need future/repeated CECTs.
摘要：
■与风湿病学部合作，过敏和免疫学，我们的研究旨在回顾既往对碘化造影剂(ICM)有超敏反应的患者的治疗结果,并提出改进的工作流程.
■接受对比增强计算机断层扫描（CECT）的患者被分为3类（明确，未经证实和不准确)基于其对比超敏反应标签的可能性。可以为患者提供不同的ICM，接收相同的ICM，或转介给过敏症专科医生作进一步评估。有4个结果：（1）耐受替代ICM；（2）再次耐受相同的ICM；（3）患者对替代或原始ICM产生超敏反应；（4）CECT推迟到过敏专家评估。在干预前后进行比较，看看患者的预后是否得到改善。
■有132名患者共进行了154次就诊（90.3%有造影剂超敏反应）。干预后，因术前用药而推迟的就诊次数减少(81.0%至34.7%)。过敏反应减少（从42.9%到14.3%）。在过敏症专科医生评估的12名患者中，6可以继续使用相同或替代的ICM，建议4人放弃进一步的造影剂给药，2人正在等待用第三种药物进行测试。
■放射科医生的积极干预可以减少推迟的数量，转换或取消CECT研究，以及减少不良过敏样事件的数量。放射科医生和过敏症医生之间针对特定病例的直接合作可能对可能需要未来/重复CECT的患者有所帮助。
■接受对比增强计算机断层扫描（CECT）的患者被分为3类（明确，未经证实和不准确)基于其对比超敏反应标签的可能性。可以为患者提供不同的ICM，接收相同的ICM，或转介给过敏症专科医生作进一步评估。有4个结果：（1）耐受替代ICM；（2）再次耐受相同的ICM；（3）患者对替代或原始ICM产生超敏反应；（4）CECT推迟到过敏专家评估。在干预前后进行比较，看看患者的预后是否得到改善。
■有132名患者共进行了154次就诊（90.3%有造影剂超敏反应）。干预后，因术前用药而推迟的就诊次数减少(81.0%至34.7%)。过敏反应减少（从42.9%到14.3%）。在过敏症专科医生评估的12名患者中，6可以继续使用相同或替代的ICM，建议4人放弃进一步的造影剂给药，2人正在等待用第三种药物进行测试。
■放射科医生的积极干预可以减少推迟的数量，转换或取消CECT研究，以及减少不良过敏样事件的数量。放射科医生和过敏症医生之间针对特定病例的直接合作可能对可能需要未来/重复CECT的患者有所帮助。
