The effects of the 2022 computed tomography IV contrast shortage on the emergency department diagnosis of abdominal pathology

Background: A COVID-19 lockdown in China resulted in a global disruption in IV contrast media production, which resulted in a hospital system advisory limiting contrast studies. The purpose of this study was to describe the effects of the IV contrast shortage on the ED diagnosis of emergent abdominopelvic pathology. Methods: This was a retrospective multi-center study performed across six EDs. Adult patients with a chief complaint of "Abdominal Pain" who had a CT abdomen/pelvis during the contrast shortage (May 12, 2022 -June 29, 2022) were included; a control group (April 11, 2022-May 11, 2022) was included as wel l. Results: There were 1003 patients included during the contrast shortage period, and 775 patients in the control group. During the contrast shortage period, 464 (46 %) patients had CT scans with IV contrast, compared to 653 (84 %) during the control period. There was not a significant increase in repeat/secondary IV CTs ordered during the ED encounter during the contrast shortage period compared to the control period (4, 0.4 % versus 3, 0.4 %). In reviewing all CTs ordered during the ED encounter, within 72-h of admission, or during a 72-h revisit, there were no cases of missed important diagnoses during the contrast shortage period or the control period. Conclusion: We did not identify differences in diagnoses during the contrast shortage period compared to the control period, and did not identify any missed important diagnoses as a consequence of the IV contrast shortage. (c) 2024 Published by Elsevier Inc.