Active surveillance on iodinated contrast media-induced reactions and associated factors among patients undergoing radiology diagnostic and intervention at tertiary hospitals in Ilala municipal

Abstract

ABSTRACT Background: Exposure to iodinated contrast medium (ICM), particularly in high doses, poses risks of organ toxicities, especially to the kidneys and cardiovascular system, leading to acute and delayed reactions. Documenting these reactions is vital for patient safety, risk management, pharmacovigilance, and medico-legal considerations. As imaging procedures increase in sub-Saharan Africa, the risk of ICM-induced reactions may rise, yet studies on these complications remain limited in low-resource settings like Tanzania. Objective: To assess iodinated contrast media-induced reactions and associated factors among patients undergoing radiology diagnostic and intervention at two Tertiary Hospitals in Ilala Municipal. Methods: This observational prospective cohort study, conducted from March to May 2024 in two tertiary hospitals in Ilala Municipal, enrolled 283 patients undergoing iodinated contrast-based procedures. The study utilized the SPSS version 23D statistical package, to analyze the patients’ profile, the incidence of Iodinated Contrast Media-induced reactions and to determine the risk factors associated with adverse reaction with a statistical significance set at p < 0.05. Results: The study included 283 patients. The overall incidence of ICM-induced reactions was 39.2%, with acute reactions such as gastrointestinal (27.9%), neurological (18.0%), and dermatological (13.5%) being common, while delayed reactions were mainly affecting renal function (6.3%). Associated factors included normal weight (RR = 1.445, p = 0.025), overweight (RR = 1.305, p = 0.043), neurological (RR = 1.496, p = 0.007), cardiopulmonary (RR = 1.335, p = 0.045), and oncological conditions (RR = 1.350, p = 0.039), as well as a history of anemia (RR = 1.490, p = 0.003). Diabetes mellitus was protective (RR = 0.540, p = 0.033), whereas stage 2 renal failure was linked to a higher risk (RR = 2.143, p = 0.009). Conclusion: ICM-induced reactions were common, with acute reactions more frequent than delayed ones, primarily affecting the gastrointestinal, neurological, and dermatological systems, while delayed reactions impacted renal function. Significant risk factors included BMI, specific clinical indications, and a history of anemia, while diabetes was protective.