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Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
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Predictors of Contrast Extravasation in the Emergency Department: A Case-Control Multi-Center Retrospective Study.

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Ultrasound-guided peripheral IV placement increases the risk of intravenous contrast extravasation (IVCE) in emergency department patients. Substance abuse also emerged as a significant risk factor for IVCE.

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Area of Science:

  • Emergency Medicine
  • Radiology
  • Patient Safety

Background:

  • Intravenous contrast extravasation (IVCE) is a rare complication of contrast-enhanced imaging.
  • IVCE can lead to severe outcomes including tissue necrosis and prolonged emergency department (ED) stays.
  • Limited research exists on IVCE risk factors within the ED setting.

Purpose of the Study:

  • To identify clinical risk factors associated with IVCE in ED patients.
  • To analyze data from contrast-enhanced computed tomography (CT) scans.

Main Methods:

  • A multicenter retrospective case-control study was conducted.
  • 141 IVCE cases were matched with 266 controls from January 2016 to October 2023.
  • Multivariable logistic regression analyzed factors related to IVCE.

Main Results:

  • Ultrasound-guided peripheral IV (USGIV) placement was associated with a 3.67-fold increased odds of IVCE (p < 0.001).
  • Substance abuse was linked to an 1.86-fold increased risk of IVCE (p = 0.036).
  • IVCE patients experienced significantly longer ED stays (653 min vs. 525 min).

Conclusions:

  • USGIV placement is a significant risk factor for IVCE in the ED.
  • Substance abuse is also associated with a higher risk of IVCE.
  • Further prospective research is recommended to validate findings and explore additional risk factors.