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Vascular access infection: survival or mortality
Sachiko Hirotani1, Kotaro Kai1, Kazuhiro Iwatoh1
1Kidney Center, Surgery, Tokyo Women's Medical University, Tokyo - Japan.
The Journal of Vascular Access
|September 10, 2015
Summary
Delayed treatment for arteriovenous graft (AVG) infection led to sepsis and death in 11 patients. Early intervention is crucial to prevent secondary infections and improve outcomes for vascular access infections.
Area of Science:
- Infectious Diseases
- Vascular Surgery
- Critical Care Medicine
Background:
- Arteriovenous graft (AVG) infections are a serious complication in patients requiring vascular access.
- Prompt diagnosis and management are essential to prevent severe outcomes such as sepsis.
Purpose of the Study:
- To analyze risk factors and outcomes in patients with fatal AVG infections.
- To compare characteristics of fatal AVG infections with those of survivors.
Main Methods:
- Retrospective analysis of 11 fatal AVG infection cases (1996-2013).
- Comparison with 23 surviving AVG infection cases during the same period.
- Review of clinical data including C-reactive protein (CRP) levels, time to intervention, and blood culture results.
Main Results:
- All 11 deaths were attributed to sepsis.
- Fatal cases showed higher initial CRP levels and longer duration from fever onset to vascular access (VA) hemostasis/removal compared to survivors.
- Methicillin-resistant Staphylococcus aureus (MRSA) was frequently identified in fatal cases, while survivors often had methicillin-sensitive Staphylococcus aureus (MSSA).
Conclusions:
- Delayed treatment of VA infections can lead to secondary infectious foci and unresolved sepsis.
- Early initiation of treatment for AVG infections is critical to prevent disseminated infection and improve patient survival.
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