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在无关住院期间偶然的AVF形成与门诊AVF形成相比,与更糟糕的结果有关
Muhammad Saad Hafeez1, Othman M Abdul-Malak1, Katherine M Reitz1
1Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
The journal of vascular access
|March 28, 2024
概括
与门诊AVF创建相比,在住院期间创建动脉静脉 (AVF) 会导致更糟糕的结果,包括较高的死亡率和较少的成功片成熟,而不是门诊AVF创建.
科学领域:
- 血管外科 血管外科
- 腎臟病學 (nephrology) 是一種醫學專業.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 动脉静脉 (AVF) 的产生对于血液透析的准入至关重要.
- 住院AVF创建有时是为了患者的方便和遵守而选择的.
- 住院患者和门诊患者创建AVF的结果需要彻底评估.
研究的目的:
- 为了比较动脉静脉囊在住院治疗期间与门诊治疗中的安全性和有效性.
- 确定两种方法之间结果的潜在差异.
主要方法:
- 美国脏数据系统 (2012-2017) 的回顾性分析.
- 在住院和门诊AVF创建组之间比较安全结果 (不良事件,死亡率) 和囊成熟率.
- 利用后勤回归,竞争风险回归和倾向得分匹配进行强大的分析.
主要成果:
- 住院AVF创建 (7.1%的病例) 与老年患者,更高的黑人种族率和更多的心血管并发症有关.
- 住院组的患者经历了显著更高的30天不良事件,整体并发症和全因死亡率.
- 在住院患者组中,一年的囊成熟和成功的两针管在住院患者组明显较低 (sHR = 0.68).
结论:
- 在住院期间偶然形成动脉静脉囊与较差的患者结局有关.
- 这些不良结果包括增加的死亡率,术后并发症和减少囊成熟.
- 门诊AVF创建似乎是一个更安全,更有效的方法.
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