Related Experiment Video
Updated: Aug 12, 2025
05:34
5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats
Published on: April 4, 2025
752
A decision-making algorithm proposal for PICCs and midlines insertion in patients with advanced kidney disease: A
Arianna Bartoli1, Maurizio Gallieni1,2, Chiara Cogliati1
1Department of Biomedical and Clinical Sciences "Luigi Sacco," University of Milan, Luigi Sacco Hospital, Milan, Italy.
The Journal of Vascular Access
|February 2, 2023
Summary
Charlson Comorbidity Index (CCI) and Beclap score effectively predict 2-year mortality in patients with peripherally inserted central catheters (PICCs) or Midlines. These scores can guide vascular access device decisions in chronic kidney disease (CKD) patients.
Area of Science:
- Nephrology
- Vascular Access
- Medical Informatics
Background:
- Current guidelines recommend against peripherally inserted vascular access devices (PVADs) in patients with estimated glomerular filtration rate (eGFR) <45 mL/min.
- Severe chronic kidney disease (CKD) often presents a poor prognosis, necessitating careful consideration of treatment risks and benefits.
Purpose of the Study:
- To assess the 2-year mortality in patients with PICCs or Midlines using the Charlson Comorbidity Index (CCI) and Beclap score.
- To determine if CCI and Beclap scores can guide PVAD implantation decisions in CKD patients with high predicted mortality.
Main Methods:
- A retrospective analysis of 131 patients with PICCs or Midlines inserted between October 2018 and November 2019.
- Calculation of CCI, Beclap score, and eGFR at catheter insertion, followed by a 2-year mortality assessment.
Main Results:
- The 2-year mortality rate was 57.3% among the enrolled patients.
- Beclap score cutoff of 15 and CCI cutoff of 5 demonstrated good sensitivity and specificity in predicting mortality across different patient subgroups, including those with eGFR <45 mL/min.
Conclusions:
- CCI and Beclap score are reliable predictors of 2-year mortality.
- These scores can aid clinicians in vascular access device selection for CKD patients, offering an alternative to relying solely on renal function.
Related Concept Videos
01:28Chronic Kidney Disease III: Interprofessional Care
66
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
66
01:20Acute Kidney Injury V: Interprofessional Care
39
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
39
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
50
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
50
01:28Cardiac Catheterization I: Pre-Procedure Overview
102
Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
102
01:18Chronic Kidney Disease IV: Nursing Management
38
Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
38
01:29Endocarditis IV: Nursing Management
22
Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
22