SYSTEMATIC REVIEW article
Front. Radiol.
Sec. Emergency Radiology
Volume 5 - 2025 | doi: 10.3389/fradi.2025.1656949
Predictors of Acute Adverse Reactions to Non-Ionic Iodinated Contrast Media in CT Imaging: A Systematic Review and Meta-Analysis
Provisionally accepted
- 1NorthSichuan Medical Co1lege, nanchong, China
- 2NorthSichuan Medical Co1lege, chongqing, China
- 3Department of Nursing, Affiliated Hospital of North Sichuan Medical College, nanchong, China
- 4Chongqing University FuLing Hospital, chongqing, China
- 5Army Characteristic Medical Center Of PLA, chongqing, China
- 6Chongqing General Hospital, Chongqing University, chongqing, China
- 7Chongqing General Hospital, Chongqing, China
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Background: Iodinated contrast media-acute adverse reactions (ICM-AARs) are frequent and clinically significant complications associated with radiological imaging. Despite investigation of their risk factors, there is no consensus, and no comprehensive synthesis has been conducted. This systematic review and meta-analysis aimed to investigate the factors influencing ICM-AARs. Methods: A systematic search for studies published in Chinese or English up to 22 July 2024 in the PubMed, Web of Science, Cochrane Library, Embase, CNKI, WanFang, CQVIP, and SinoMed databases was conducted. Studies on patients undergolng contrast-enhanced CT examinations with nonionic ICM were selected. The primary outcome measures were risk factors associated with ICM-AARs. The studies were analyzed for heterogeneity using the Q-test and I² statistic, while publication bias was assessed using funnel plots, Egger’s test, and Begg’s test. Stata 17 software was used for the meta-analysis. Results: Seventeen studies were included, encompassing 2,576,446 CT-enhanced examinations. Of these, 11,621 acute adverse reactions were reported, with a mean incidence of 0.45% and a quality score of ≥7. The meta-analysis showed that female sex (OR=1.27, 95% CI=1.13,1.41), age <35 years (OR=1.77, 95% CI=1.19, 2.64), high body mass index (OR=1.06, 95% CI=1.01,1.10), type of medical visit (outpatient) (OR=2.23, 95% CI=1.01,4.93), history of adverse ICM reactions (OR=11.03, 95% CI=2.25,53.97), history of other allergies (OR=3.16, 95% CI= 1.27,7.84), history of asthma (OR=1.75, 95% CI=1.19,2.57), hyperthyroldism (OR=4.59, 95% CI=1.65,12.82), and type of ICM (OR=2.27, 95% CI=1.68,3.06) were risk factors for ICM-AARs. Age >60 years (OR=0.71, 95% CI=0.53,0.95), pre-injection medication (OR=0.56, 95% CI=0.39,0.79), and hypertensive disorders (OR=0.78, 95% CI=0.65,0.94) were identified as protective against ICM-AARs. Conclusions: The incidence of ICM-AARs is influenced by a variety of clinical and demographic factors. Healthcare professionals may benefit from dynamically assessing patient-specific risk factors and considering targeted preventive measures for high-risk groups, particularly in populations similar to those studied.
Keywords: Iodine, Contrast Media, Acute adverse reactions, Influencing factors, Meta-analysis
Received: 30 Jun 2025; Accepted: 12 Aug 2025.
Copyright: © 2025 Liu, Cheng, Zhu, Long, Li, Cui, Li and Mu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhangping Mu, Chongqing General Hospital, Chongqing, China
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