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The Incidence of Various Types of Systemic Reactions Related to Epidural Steroid
Injections: A Prospective Observational Study
#MMPMID29520188
Lee GY
; Lee JW
; Yeom JS
; Kim KJ
; Shin HI
; Kang HS
Korean J Radiol
2018[Mar]; 19
(2
): 301-310
PMID29520188
show ga
OBJECTIVE: To evaluate the incidence, types and association of systemic reactions
after an epidural steroid injection (ESI) with patient demographics, ESI factors
and repeated occurrence of an ESI. MATERIALS AND METHODS: This prospective
observational study was approved by the Institutional Review Board of our
hospital, and written informed consent was obtained from all the participants.
From October to December 2011, systemic reactions at 2 weeks after 960 ESIs among
885 patients were measured. Patients were evaluated by phone interviews to obtain
the patients' demographics, history of previous ESI, ESI factors, and ESI
reoccurrence. Statistical analyses were performed using the chi-square tests,
Fisher's exact tests and a binary logistic regression analysis. RESULTS: Overall,
557 types of systemic reactions occurred after 292 injections (30.4%) of a total
of 960 ESIs in which facial flushing was most common (131/557, 23.5%) and 144
ESIs were followed by a mixed form of systemic reactions (49.3%). Age of 62 years
or younger (odds ratio [OR], 2.361), female sex (OR, 1.674), and history of
diabetes mellitus (OR, 1.681) were significant risk factors in the occurrence of
systemic reactions after an ESI. In 73 patients with repeated ESI, 14 patients
re-experienced systemic reactions (19.2%), of which twelve re-experienced the
same systemic reaction as the previous one. CONCLUSION: Systemic reactions
followed about 30% of ESIs, and more commonly occurred in patients 62 years of
age or younger, women, and diabetic patients. Half of the patients experienced a
mixed form of systemic reactions. Patients with recurring systemic reactions tend
to re-experience the same systemic reaction as the prior one after an ESI.
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