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Reducing Intravenous Contrast Utilization for CT: A Health System-Wide Intervention With Sustained Impact.

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Summary
This summary is machine-generated.

Standardized contrast dosing for CT scans significantly reduced iodinated contrast media volume by over 10% for more than a year. This initiative proved effective despite a global iohexol shortage.

Keywords:
CTContrast volumeiodinated contrastiodinated contrast shortage

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Area of Science:

  • Radiology
  • Medical Imaging
  • Health System Management

Background:

  • The global shortage of iohexol, a common iodinated contrast media, necessitated strategies to optimize its use in computed tomography (CT) examinations.
  • Variations in contrast media administration can impact patient safety, resource allocation, and diagnostic quality.

Purpose of the Study:

  • To evaluate the impact of implementing standardized contrast media dosing protocols on utilization volumes.
  • To assess the persistence of these changes before, during, and after a period of contrast media shortage.

Main Methods:

  • A retrospective study analyzed CT encounter data from a 12-site health system over 17 months.
  • Standardized contrast doses for 13 common CT examinations were implemented on May 23, 2022.
  • Contrast utilization was compared across preintervention, intervention, and postintervention periods using statistical analyses, including multivariable linear regression.

Main Results:

  • Mean contrast dose per CT examination decreased by 12.7% (P < .001) after standardization, from 89.3 mL to 78.0 mL.
  • This reduction was sustained postintervention (80.4 mL, -10.0% change; P < .001), with 9 of 12 sites maintaining decreased utilization.
  • Patient weight, sex, and performing site were identified as factors influencing contrast dose variations.

Conclusions:

  • Standardized contrast media dosing is an effective strategy for rapidly reducing iodinated contrast media utilization in CT.
  • The observed decrease in contrast media use persisted for over a year, demonstrating the long-term benefits of standardized protocols.