Iodine 조영제의 부작용 감소를 위한 프로토콜 변경 전후의 사례 분석

Case Analysis Before and After the Protocol Amendment to Reduce Adverse Reactions to Iodinated Contrast Agents

Purpose To reduce adverse reactions of contrast agents, we amended the standard protocol of drug committee in the hospital, expanding the range of drug treatment before computed tomography(CT) for the patients with a history of a previous reaction. Analyzing the frequency of adverse reactions by severity before and after the protocol amendment, we aimed to confirm the reliability of new protocol and to identify the risk groups by the class. Materials and methods The subjects for the data review were 120,322 adults who examined by CT with contrast agents as outpatient department in a general hospital. The subjects with mild symptoms were not treated during the period before protocol amendment from Jan. to Sept. 2008 while all adverse reactions related to contrast agents, occurred after the medicinal treatment for all the patients who had the previous history of adverse reactions to contrast agents, were compared and analyzed by severity during the period after the protocol amendment from Oct. 2008 to Aug. 2009. In addition, frequency of adverse reactions by type of contrast agent, sex, and age were examined to identify the risk factors by class. Results The mild adverse reactions patients who required the treatments among the patients with adverse reactions had decreased by 5.24% after the protocol amendment compared to the period before the amendment, and severe patients decreased by 9.40%. Regarding the analysis by sex, the females showed 0.08% and 0.37% in mild and severe cases, respectively, higher than males. For the analysis by age, the correlation was not shown. The number of adverse reactions was not proportional to iodine content. Conclusion The amended protocol was concluded to be useful for decreasing adverse reactions patients with contrast agent, since the potential of mild and severe adverse reactions occurrences which require the medical treatment was shown low after the treatment for the patients with the previous reactions of contrast agent.