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The Effect of an Iodinated Contrast Material Shortage on Ordering Patterns in the Emergency Department

Introduction Iodinated contrast media (ICM) is essential to emergency department care in differentiating and delineating life-threatening pathologies. In May 2022, due to the COVID-19 outbreak, there was an unprecedented disruption in the manufacturing of iodinated contrast. The primary goal of this...

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Autores principales: Hahn, Barry, Chacko, Jerel, Mohan, Mukund, Mathews, Kurien, Greenstein, Josh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9867569/
https://www.ncbi.nlm.nih.gov/pubmed/36694480
http://dx.doi.org/10.7759/cureus.32846
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author Hahn, Barry
Chacko, Jerel
Mohan, Mukund
Mathews, Kurien
Greenstein, Josh
author_facet Hahn, Barry
Chacko, Jerel
Mohan, Mukund
Mathews, Kurien
Greenstein, Josh
author_sort Hahn, Barry
collection PubMed
description Introduction Iodinated contrast media (ICM) is essential to emergency department care in differentiating and delineating life-threatening pathologies. In May 2022, due to the COVID-19 outbreak, there was an unprecedented disruption in the manufacturing of iodinated contrast. The primary goal of this study was to describe the effects of an ICM shortage on the ordering patterns of emergency medicine physicians. Methods This was a retrospective, observational study with a pre-/post-test design. The study included two 28-day periods. All subjects who underwent a CT were included in the study. The subgroup of patients who underwent a repeat CT with ICM contrast within 1-24 hours was identified. Results During the pre- and post-implementation study periods, 4,574 and 3,973 CT studies were performed. The median length of stay (p=0.013) and time to first CT (p<0.001) both decreased during the post-implementation period. During the post-implementation period, more non-contrast CTs were ordered (p<0.001). During the post-implementation period, there was an increase in non-contrast studies followed by a repeat study with contrast (p=0.003). Conclusions A global ICM shortage resulted in a shift in the ordering patterns of Emergency Medicine (EM) physicians. More non-contrast CT scans were ordered. However, there was also an increase in repeat imaging with ICM material.
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spelling pubmed-98675692023-01-23 The Effect of an Iodinated Contrast Material Shortage on Ordering Patterns in the Emergency Department Hahn, Barry Chacko, Jerel Mohan, Mukund Mathews, Kurien Greenstein, Josh Cureus Emergency Medicine Introduction Iodinated contrast media (ICM) is essential to emergency department care in differentiating and delineating life-threatening pathologies. In May 2022, due to the COVID-19 outbreak, there was an unprecedented disruption in the manufacturing of iodinated contrast. The primary goal of this study was to describe the effects of an ICM shortage on the ordering patterns of emergency medicine physicians. Methods This was a retrospective, observational study with a pre-/post-test design. The study included two 28-day periods. All subjects who underwent a CT were included in the study. The subgroup of patients who underwent a repeat CT with ICM contrast within 1-24 hours was identified. Results During the pre- and post-implementation study periods, 4,574 and 3,973 CT studies were performed. The median length of stay (p=0.013) and time to first CT (p<0.001) both decreased during the post-implementation period. During the post-implementation period, more non-contrast CTs were ordered (p<0.001). During the post-implementation period, there was an increase in non-contrast studies followed by a repeat study with contrast (p=0.003). Conclusions A global ICM shortage resulted in a shift in the ordering patterns of Emergency Medicine (EM) physicians. More non-contrast CT scans were ordered. However, there was also an increase in repeat imaging with ICM material. Cureus 2022-12-22 /pmc/articles/PMC9867569/ /pubmed/36694480 http://dx.doi.org/10.7759/cureus.32846 Text en Copyright © 2022, Hahn et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Emergency Medicine
Hahn, Barry
Chacko, Jerel
Mohan, Mukund
Mathews, Kurien
Greenstein, Josh
The Effect of an Iodinated Contrast Material Shortage on Ordering Patterns in the Emergency Department
title The Effect of an Iodinated Contrast Material Shortage on Ordering Patterns in the Emergency Department
title_full The Effect of an Iodinated Contrast Material Shortage on Ordering Patterns in the Emergency Department
title_fullStr The Effect of an Iodinated Contrast Material Shortage on Ordering Patterns in the Emergency Department
title_full_unstemmed The Effect of an Iodinated Contrast Material Shortage on Ordering Patterns in the Emergency Department
title_short The Effect of an Iodinated Contrast Material Shortage on Ordering Patterns in the Emergency Department
title_sort effect of an iodinated contrast material shortage on ordering patterns in the emergency department
topic Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9867569/
https://www.ncbi.nlm.nih.gov/pubmed/36694480
http://dx.doi.org/10.7759/cureus.32846
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