血液透析的时间趋势 在头第一时代,血液透析的时间趋势在头第一时代的访问创建
James J Fitzgibbon1, Patrick Heindel1, Abena Appah-Sampong1
1Department of Surgery, Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital/Harvard Medical School, Boston, MA; Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital/Harvard Medical School, Boston, MA.
Journal of vascular surgery
|February 22, 2024
概括
前臂动脉静脉 (AVFs) 仍然未被充分利用用于血液透析,尽管有国家倡议,但其比例没有变化. 上臂动脉静脉移植 (AVG) 在老年,黑人,女性和弱势患者中增加.
科学领域:
- 血管外科 血管外科
- 腎臟病學 (nephrology) 是一種醫學專業.
- 公共卫生 公共卫生
背景情况:
- 前臂动脉静脉 (AVF) 是指导方针建议的血液透析接入.
- 缺乏关于前臂与上臂AVF和动脉静脉移植 (AVG) 创建趋势的人口级数据.
研究的目的:
- 分析第一次前臂与上臂AVF和AVG的创建时间趋势.
- 评估国家举措对AVF安置率的影响.
主要方法:
- 来自血管质量倡议数据库的52,170次首次上肢血液透析访问 (2012-2022) 的回顾性分析.
- 时间序列分析以根据位置 (前臂与上臂) 评估AVF和AVG创建趋势.
- 间断时间序列分析,以评估2015年"先导管先导管最后"倡议的影响.
主要成果:
- 上臂AVF占57.9%,前臂AVF占25.2%;整体AVF率没有显著变化.
- 前臂AVG显著下降 (1.8%至0.7%),而上臂AVG则数量上升 (13.9%至18.2%).
- 在男性和弱势患者中,前臂AVF的发生率下降;在女性,黑人,老年人和弱势患者中,上臂AVG的发生率增加. 菲斯图拉第一倡议没有影响AVF费率.
结论:
- 首次AVF率停滞不前,前臂AVF仅占访问的四分之一,尽管有国家推广.
- 在脆弱患者群体 (老年人,黑人,女性,弱势群体) 中观察到,上臂AVG的使用增加.
- 需要进一步的研究来了解影响前臂AVF放置的因素,并确定实践中的差异.
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