What proportion of patients undergoing fluoroscopy‑guided procedures and CT are alive or dead: 12-year study

We evaluated long-term survival in patients undergoing fluoroscopy-guided procedures (FGPs), and CT over a 12-year period.

This retrospective study included 54,854 patients who underwent ≥ 1 FGP at a tertiary-care hospital from 2013 to 2022. Fluoroscopy dose was assessed using kerma-area-product (KAP), while CT dose was obtained from Radimetrics, which estimates organ and effective dose using Monte Carlo methods with ICRP 103 weighting factors. CED from fluoroscopy and CT were stratified into five dose groups (A: >0 to < 10 mSv, B: 10 to < 50 mSv, C: 50 to < 100 mSv, D: 100 to < 250 mSv, E: ≥250 mSv). Vital status and date of death were retrieved from the institutional registry through 2024. Mortality was evaluated at ≤ 5 years and ≤ 10 years following the first FGP.

Overall, as of the end of December 2024, 45,765 patients (83.4%) were alive. Mortality proportions increased progressively from Groups A through E. Within Groups A-C, deceased patients were older than survivors (p < 0.001). Mean age at death decreased with dose, lowest in Group E (63.6 years). Mean CED was higher in deceased patients in Groups A-D (p < 0.001), but not in Group E (p = 0.224).

Although early mortality in high-dose groups likely reflects underlying disease burden, many patients with CED ≥ 50-250 mSv survived 5-10 years and therefore remain at risk for late radiation effects. These findings emphasize the need for dose tracking, justification, and awareness of cumulative exposure in patients undergoing repeated imaging.