FREQUENCY, SEVERITY, AND RISK FACTORS OF CONTRAST-INDUCED ADVERSE REACTIONS AMONG PATIENTS UNDERGOING CONTRAST-ENHANCED CT EXAMINATIONS AT THE RADIOLOGY DEPARTMENT, LADY READING HOSPITAL, PESHAWAR

Abstract

Background: Contrast-enhanced computed tomography (CT) is widely used for diagnosis and disease evaluation. Although modern non-ionic iodinated contrast media are considered relatively safe, adverse reactions may occasionally occur, ranging from mild symptoms to rare, severe, life-threatening events.To determine the frequency, severity, clinical pattern, and associated risk factors of contrast-induced adverse reactions among patients undergoing contrast-enhanced CT at the Radiology Department, Lady Reading Hospital, Peshawar. Methods: A hospital-based descriptive cross-sectional study was conducted on 1,000 consecutive patients undergoing contrast-enhanced CT, enrolled by non-probability consecutive sampling. Data on demographics, examination type, contrast agent, comorbidities, allergy history, and reaction occurrence/severity were recorded on a structured proforma and analysed using SPSS. Results: The study population had a mean age of 62.4 ± 17.6 years (range 23–95 years); 566 (56.6%) were male and 434 (43.4%) female. Iohexol (256, 25.6%) and iopamidol (210, 21.0%) were the most frequently used agents. Comorbidities were present in 312 (31.2%) patients, most commonly hypertension (75, 7.5%) and diabetes mellitus (64, 6.4%). An adverse reaction occurred in 4 of 1,000 patients (0.4%; 95% CI 0.16–1.02%): 3 (0.3%) mild and 1 (0.1%) moderate, with no severe or fatal reactions. Reactions occurred within 1–8 minutes of injection, most commonly with iopamidol, and all resolved fully with observation and/or symptomatic treatment (antihistamines, corticosteroid, and intravenous fluids in the moderate case). Conclusion: Contrast-induced adverse reactions were uncommon (0.4%) in this cohort and were predominantly mild and self-limiting, consistent with international literature. These findings support the overall safety of non-ionic contrast media in local practice while underscoring the continued need for vigilant monitoring and emergency preparedness during contrast-enhanced CT.

Keywords: Computed tomography; iodinated contrast media; adverse reactions; contrast-induced reactions; radiology; patient safety; Peshawar.