Frequency and risk factors of contrast media extravasation in 378,082 intravenous contrast-enhanced CT scans

To determine the occurrence and risk factors of contrast media extravasation (CME) during contrast-enhanced computed tomography (CECT).

This is an observational retrospective study. 378,082 cases who underwent CECT scans between January 2017 and December 2023 were initially included. The total and annual incidence of CME were examined. Subsequently, 155,547 cases with sufficient information were finally included for risk analysis. Risk factors of CME were investigated using logistic regression with generalized estimating equation analyses. Besides, risk factors of large-volume (≥50 ml) CME were also surveyed.

The incidence of CME decreased steadily from 0.18 % in 2017 to 0.07 % in 2023, with an overall rate of 0.11 % (431/378,082). Multivariate analysis revealed that female [odds ratio (OR) = 1.683; P < 0.001], age (OR = 1.017; P < 0.001), BMI < 18.5 (OR = 2.083; P < 0.001), emergency patient (OR = 1.950; P < 0.001), diabetes mellitus (OR = 2.650; P = 0.001), iohexol injection (OR = 1.721; P = 0.006), iopamidol injection (OR = 1.640; P = 0.006), and without saline flush (OR = 3.336; P < 0.001) were the risk factors of CME. 24 ≤ BMI < 28 (OR = 0.686; P = 0.002) was a protective factor for CME. In addition, male, BMI ≥ 28, 18-gauge injection, elbow fossa injection, and upper-arm injection were the risk factors for large-volume CME.

CME was uncommon during CECT. Several risk factors identified for CME and large-volume CME may have the potential to reduce the occurrence and severity of CME.