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动脉静脉接入阶段 (AVAS) 分类的验证:一个前性的,国际多中心研究

Katerina Lawrie^1,2, Petr Waldauf^2,3, Peter Balaz^2,4,5,6

¹Department of Transplantation Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.

Clinical kidney journal

|September 27, 2024

概括

动脉静脉接入阶段 (AVAS) 分类有效地预测了血管接入的创造,特别是当临床医生跟踪时,显著降低了早期失败率. 在复杂的案例中,准确性下降,突出了需要仔细应用的必要性.

科学领域:

腎臟病學 (nephrology) 是一種醫學專業.
血管外科血管外科
医疗成像医学成像

背景情况:

动脉静脉接入阶段 (AVAS) 分类系统将上肢血管分类为血管接入 (VA) 适用性.
它将患者分为三个组:AVAS1 (原生),AVAS2 (假肢移植) 和AVAS3 (不适合常规VA).

研究的目的:

为了前性地验证AVAS分类系统在预测血管接入创造和结果方面的有效性.
在评估者中评估AVAS评估的准确性和一致性.

主要方法:

一项前性国际观察性研究 (NCT04796558) 招募了11个中心的1034名患者.
收集的数据包括人口统计,风险因素,船舶参数,VA类型,AVAS类别和早期VA故障.
使用百分比协议评估AVAS预测能力和评估者之间的一致性;使用Pearson的Chi-squared测试比较早期失败率.

主要成果:

在AVAS分布中,有AVAS1 (91.2%),AVAS2 (7.2%) 和AVAS3 (1.6%). 评估者之间达成的共识达到了89%.
与创建访问相比,AVAS预测的准确性为79%,超过临床医生的预测 (62.1%).
非传统的VA的早期失效率 (20%) 比传统的VA (9.3%,P=.002) 高.

结论:

由于复杂的决策和船舶保存需求,AVAS在预测VA创建方面是有效的,尽管在较高的类中,由于复杂的决策和船舶保存需求,准确性会降低.
遵循AVAS指导方针显著降低了早期血管接入失败率.

关键词:

动脉静脉状囊动脉静脉状囊分类系统的分类系统.血液透析的访问权限多中心研究多中心研究.血管映射血管映射

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