Biomaterial Database

Selective use of low-osmolality contrast agents for i.v. urography and CT: safety and effect on cost. 1994

T B Hunter, and J Dye, and J F Duval

Department of Radiology, University Medical Center, Tucson, AZ 85724.

OBJECTIVE The purpose of this study was to determine if the selective use of low-osmolality contrast material for excretory urography and CT is safe and if it saves money. METHODS At the University Medical Center in Tucson, a questionnaire was developed to identify high-risk patients who would benefit from the use of a low-osmolality contrast agent. High-risk patients were defined as those with a history of a reaction to contrast material, severe allergies, asthma, severe cardiac disease, multiple myeloma, sickle cell disease, polycythemia, pheochromocytoma, or renal impairment. Beginning in March 1993, the questionnaire was given to all adult outpatients scheduled for daytime excretory urography and routine CT studies of the head and body. Only patients identified as high risk were given a low-osmolality (non-ionic) contrast agent. All other patients received high-osmolality (ionic) contrast material. The contrast agent chosen for a patient was determined by the person administering the questionnaire, usually a radiologic technologist. RESULTS From March 1993 through December 1993, 1114 adult daytime outpatient excretory urographic and contrast-enhanced CT studies were examined at our institution. In 235 (21%) of the studies, a low-osmolality agent was used and in 879 (79%) studies, a high-osmolality agent was used. This represented a reduction in the use of low-osmolality agents from more than 90% of patients to 21%, an annual cost reduction from $288,000 to $60,480. We observed no untoward reactions to contrast material that could be specifically attributed to the increased use of high-osmolality agents. CONCLUSIONS Selective use of low-osmolality contrast agents during excretory urography and CT can provide substantial cost savings and is not associated with a significant risk of major complications.

UI	MeSH Term	Description	Entries
D007472	Iohexol	An effective non-ionic, water-soluble contrast agent which is used in myelography, arthrography, nephroangiography, arteriography, and other radiographic procedures. Its low systemic toxicity is the combined result of low chemotoxicity and low osmolality.	Compound 545,Exypaque,Iohexol 350,Nycodenz,Omnipaque
D009994	Osmolar Concentration	The concentration of osmotically active particles in solution expressed in terms of osmoles of solute per liter of solution. Osmolality is expressed in terms of osmoles of solute per kilogram of solvent.	Ionic Strength,Osmolality,Osmolarity,Concentration, Osmolar,Concentrations, Osmolar,Ionic Strengths,Osmolalities,Osmolar Concentrations,Osmolarities,Strength, Ionic,Strengths, Ionic
D011795	Surveys and Questionnaires	Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions.	Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D011872	Radiology Department, Hospital	Hospital department which is responsible for the administration and provision of x-ray diagnostic and therapeutic services.	Hospital Radiology Department,X-Ray Departments,Department, Hospital Radiology,Department, X-Ray,Departments, Hospital Radiology,Departments, X-Ray,Radiology Departments, Hospital,X-Ray Department,Department, X Ray,Departments, X Ray,Hospital Radiology Departments,X Ray Department,X Ray Departments
D003287	Contrast Media	Substances used to allow enhanced visualization of tissues.	Radiopaque Media,Contrast Agent,Contrast Agents,Contrast Material,Contrast Materials,Radiocontrast Agent,Radiocontrast Agents,Radiocontrast Media,Agent, Contrast,Agent, Radiocontrast,Agents, Contrast,Agents, Radiocontrast,Material, Contrast,Materials, Contrast,Media, Contrast,Media, Radiocontrast,Media, Radiopaque
D003363	Cost Control	The containment, regulation, or restraint of costs. Costs are said to be contained when the value of resources committed to an activity is not considered excessive. This determination is frequently subjective and dependent upon the specific geographic area of the activity being measured. (From Dictionary of Health Services Management, 2d ed)	Cost Containment,Containment, Cost,Containments, Cost,Control, Cost,Controls, Cost,Cost Containments,Cost Controls
D003973	Diatrizoate	A commonly used x-ray contrast medium. As DIATRIZOATE MEGLUMINE and as Diatrizoate sodium, it is used for gastrointestinal studies, angiography, and urography.	Amidotrezoate,Amidotrizoate,Benzoic acid, 3,5-bis(acetylamino)-2,4,6-triiodo-,Diatrizoate Sodium,Diatrizoic Acid,Hypaque,Hypaque 50,Sodium Diatrizoate,Sodium-Magnesium Diatrizoate,Urogranoic Acid,Urothrast,Urotrast,Diatrizoate, Sodium,Diatrizoate, Sodium-Magnesium
D006785	Hospitals, University	Hospitals maintained by a university for the teaching of medical students, postgraduate training programs, and clinical research.	University Hospitals
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001130	Arizona	State of the UNITED STATES OF AMERICA bounded on the east by New Mexico, on the north by Utah, on the west by Nevada and California, and on the south by Mexico.