A325 RISK EVALUATION OF ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP)-RELATED CONTRAST MEDIA (CM) ALLERGIC REACTION AMONG PATIENTS KNOWN FOR ADVERSE REACTION TO IODINE CONTAINING PRODUCT
Bibliographic record
Abstract
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
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".