Clinical manifestations of contrast media extravasation in the emergency department and the ward

Purpose Contrast media extravasation (CME) is an adverse reaction after administration ofcontrast media during CT examinations. The purpose of this study was to evaluate the frequency,management, and outcomes of extravasations and to assess the risk factors for CME in theemergency department (ED) and the ward.Materials and Methods This retrospective study was conducted at a single academic urbanhospital from January 2013 to December 2015. We analyzed the medical records of all patientswho experienced CME after undergoing a CT scan. We compared the patients' age, sex, underlyingdisease, injection site, injection flow rate, time of CT examination, type of CT examination,and severity of injury between those in the ED and the ward.Results CME occurred in 41 (0.36%) of 114767 patients, which included 16 (0.34%) in the EDand 25 (0.37%) in the ward. Both groups were more frequent in those aged older than 60 yearsand in female. Additionally, the abdominopelvic CT type and 2-3 mL/s as the injection ratewere more common in both groups. However, CME was more frequent during the nighttime(10, 62.5%) in the ER, while it was more common in the daytime (14, 56.0%) in the ward. Severecomplications were more frequent in the ER (9, 56.3%) compared with the ward (8, 32.8%).There were no significant differences in CME between the ED and the ward. When comparingthe clinical manifestations in the mild and severe groups, the antecubital fossa (33.3% and 0%,respectively; p = 0.013) for the injection site and abdominopelvic CT (41.7% and 82.4%, respectively;p = 0.012) and CT angiography (41.7% and 5.87%, respectively; p = 0.014) for the CT examinationshowed significant differences between the mild and severe groups.Conclusion In this study, there were no significant clinical differences in CME between the EDand ward. Thus, prevention is more important than the place of admission. Radiologists andemergency physicians should pay attention to CME in the ED because it frequently occurs at night and results in more severe complications.