Risk factors associated with immediate hypersensitivity reaction to contrast media: a systematic review and meta-analysis
Bibliographic record
Abstract
Objective To determine the risk factors associated with immediate hypersensitivity reactions to contrast media (CM-IHR). Materials and methods 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 2 test. Results 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 2 = 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 2 = 87 %). Conclusions 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 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 | 0.014 | 0.031 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.018 | 0.041 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 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".