A325 RISK EVALUATION OF ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP)-RELATED CONTRAST MEDIA (CM) ALLERGIC REACTION AMONG PATIENTS KNOWN FOR ADVERSE REACTION TO IODINE CONTAINING PRODUCT
Notice bibliographique
Résumé
Few cases of ERCP-related CM adverse reactions have been reported in the current literature. Patients known for any allergy or a prior allergy-like reaction to CM are considered at higher risk of CM adverse reaction. There is a lack of standardisation in practice regarding premedication prophylaxis for at risk patients undergoing ERCP and few data to guide the practitioners. Our goal is to evaluate the risk of CM allergic like reaction in a group of patients with a past-history of reaction to iodine product undergoing ERCP. A retrospective chart review study was performed of all adult patients who underwent ERCP at our single centre from January 2010 to December 2015. Data regarding demographics, history of allergy (especially iodine), ERCP indication and post-ERCP anaphylactoid reaction were collected for all patients. Additional data were collected for patients with a past-history of reaction to iodine product: hospitalisation status, premedication prophylaxis (corticosteroid and antihistaminic), type of contrast used, post-ERCP time of observation and any ERCP related CM reaction. Severe reaction was defined as an anaphylactic shock or an allergic-like reaction with hypotension or respiratory distress. Among 1766 patients, 2295 ERCP were performed from 2010 to 2015. 828 (36.1%) ERCP were performed on patients with a past history of any allergy and 127 (5.5%) on patients with prior iodine adverse reaction. Among 2295 ERCP, no anaphylactoid or severe adverse reaction occurred. 1 (0.04%) ERCP-related CM benign reaction was reported in a patient known for penicillin allergy but no prior CM reaction; he had a delayed diffuse pruritic rash with a favorable response to medical treatment. Among 1766 patients, 75 were known for prior reaction to iodine product. Previous iodine reactions were rash (n=22), oedema (n=16), severe CM reaction (n=10) or other-not specified (n=27). Among 127 ERCP performed on these patients, 121 procedures were done without and 6 with a premedication prophylaxis. In both groups, no ERCP-related CM reaction occurred. To our knowledge, we report the largest cohort of iodine allergic patients undergoing ERCP ever published. Among a group of patients known for prior iodine reaction, 121 ERCP were performed without premedication and no CM adverse reaction were reported. Moreover, among 2295 procedures performed, no severe ERCP-related CM adverse reaction occurred and only 1 (0.04%) benign reaction was reported. These results suggest that ERCP-related CM adverse reactions are very rare even among patients at risk for CM reaction. Therefore, we suggest CM premedication prophylaxis for ERCP should not be given routinely among patients with a past-history of CM reaction. None
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».