Risk factors associated with immediate hypersensitivity reaction to contrast media: a systematic review and meta-analysis
Bibliographic record
Abstract
<h2>Abstract</h2><h3>Objective</h3> To determine the risk factors associated with immediate hypersensitivity reactions to contrast media (CM-IHR). <h3>Materials and methods</h3> A systematic search was conducted in PubMed, Embase, Ovid, Web of Science database and the Cochrane Library up to December 2024 to identify studies in which risk factors associated with CM-IHR were explored. The Newcastle-Ottawa Scale was used to assess the risk of bias. Odds ratios (ORs) with 95% confidence intervals (CIs) for each risk factor were pooled from the selected studies. Heterogeneity was evaluated via the Higgins I<sup>2</sup> test. <h3>Results</h3> From 8,342 citations, seven were ultimately included in the meta-analysis, encompassing a total of 115,043 patients and 736,203 injections. The methodological quality was rated as high in six studies and moderate in one. Four studies investigated iodinated CM (ICM), while 3 investigated gadolinium-based contrast agent. Female sex (OR 1.46; 95 % CI 1.33–1.59) was identified as a significant risk factor for CM-IHR, and age showed an inverse association with risk (OR 0.98; 95 % CI 0.98–0.99). Asthma history was not suggested as a significant risk factor (OR 1.12; 95 % CI, 0.95–1.33; I<sup>2</sup> = 0 %). For ICM-IHR specifically, outpatient status was associated with higher risk (OR, 3.08; 95 % CI, 1.13–8.44). Notably, pooled analysis of two studies suggested a trend toward increased risk with prior history of hypersensitivity reaction to ICM; however, this association was not statistically significant and was accompanied by high heterogeneity (OR 7.49; 95 % CI, 0.42–135.09, I<sup>2</sup> = 87 %). <h3>Conclusions</h3> Our systematic review and meta-analysis suggest that female sex was a significant risk factor for CM-IHR, whereas increasing age was associated with a lower risk. Outpatient status showed a significant association with ICM-IHR. Prior history of hypersensitivity reaction to ICM was not identified as a significant risk factor. Given the small number of available studies and substantial heterogeneity, these findings should be interpreted with caution.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.012 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".