Nonionic iodinated intravenous contrast material-related reactions: incidence in large urban children's hospital—retrospective analysis of data in 12,494 patients

PURPOSE: To examine the incidence and severity of nonionic intravenous contrast material reactions in a large pediatric patient population.

MATERIALS AND METHODS: Electronic records on all consecutive patients at a tertiary care pediatric hospital who received ioversol contrast material over a 7-year period for computed tomographic or excretory urographic studies were reviewed, yielding individual contrast material injection events in 12,494 patients up to 21 years of age. There were 6600 male patients and 5894 female patients. Contrast material reactions were categorized as mild, moderate, or severe according to American College of Radiology guidelines. Logistic regression analysis was performed to evaluate effects of age, sex, season, and study year on the presence of an intravenous contrast material reaction.

RESULTS: There were 57 adverse events related to nonionic iodinated intravenous contrast material in 12,494 consecutive pediatric and young adult patients. Incidence of a contrast material reaction was 0.46% (57 of 12,494), or one in 200 patients. Incidence of a type I (mild) contrast material reaction was 0.38% (47 of 12,494), or one in 250 patients. Incidence of a type II (moderate) reaction was 0.08% (10 of 12,494), or one in 1000 patients. There were no severe (type III) reactions. The average age of patients with a contrast material reaction (12.9 years +/- 4.3 [standard deviation]) was 3.4 years older (P < .001) than the average age of all patients in the study (9.5 years +/- 5.9). There was a significant relationship between patient age and incidence of contrast material reaction per 1000 studies (P = .003), independent of sex, season, and year of study.

CONCLUSION: Adverse reactions to intravenous administration of a nonionic contrast material (ioversol) are rare in children and increase in frequency with advancing age. The great majority of reactions in children are mild.