脆弱查用于确定血液透析接入位置
Shannon M McDonnell1, Shaya Nikfar1, Matthew Blecha2
1Stritch School of Medicine, Loyola University Medical Center, Maywood, IL.
Journal of vascular surgery
|December 17, 2023
概括
与非脆弱患者相比,接受新的动脉静脉 (AV) 接入放置的脆弱患者 (PRISMA-7评分≥3) 的AV接入失败率显著更高. 虚弱性是血液透析患者AV接入不良结果的关键预测因素.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 血管外科 血管外科
- 老年病的医生 老年病的医生
背景情况:
- 为脆弱的患者选择血液透析血管接入是具有挑战性的,因为患者的偏好和接入结果.
- PRISMA-7得分可以识别脆弱性,可能会影响动脉静脉 (AV) 接入的成功.
研究的目的:
- 通过PRISMA-7评分定义的患者脆弱性与新创建的AV囊 (AVF) 和AV移植 (AVG) 的结果之间的关联.
主要方法:
- 对40名接受新AVF或AVG安置的患者进行前性队列研究.
- 在手术前使用PRISMA-7问卷评估患者的脆弱性.
- 在脆弱群体与非脆弱群体中对准成熟,感染和死亡率的分析.
主要成果:
- 虚弱患者 (53%) 的AV接入失败率 (48%) 与非虚弱患者 (5%) 相比显著更高 (P=.012).
- 虚弱患者的动脉静脉 (AVF) 显示出60%的未成熟率,而非虚弱患者的比例为0% (P=.049).
- 脆弱性 (aOR 10.19) 和年轻的年龄与访问不成熟有显著的联系.
结论:
- 患者的脆弱性是增加动脉静脉通道未能成熟的重要预测因素.
- 这些发现表明,脆弱性评估可以指导血液透析患者的血管接入选择.
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