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与最初的血管接入选择和血液透析患者中平均利用时间相关的因素
Fahrudin Masnic1, Halima Resic2, Alen Dzubur3
1Clinic for Hemodialysis, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
Annals of vascular surgery
|December 13, 2024
概括
高龄和糖尿病与初始血液透析有关. 年轻的患者,男性和高血压患者使用临时导管的时间更长,突出了永久血管接入的延迟.
科学领域:
- 病学和血管外科
- 临床流行病学临床流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 血管接入 (VA) 对血液透析 (HD) 患者至关重要.
- 临时导管 (TC) 和动脉静脉管 (AVF) 之间的选择会影响患者的治疗结果.
- 需要阐明初始VA选择和利用时间的预测因素.
研究的目的:
- 确定血液透析患者最初选择血管接入类型的预测因子.
- 要确定初始血管接入的中位利用时间.
- 确定影响初始血管接入使用时间的因素.
主要方法:
- 对387名血液透析患者进行前性队列研究.
- 随机森林算法用于初始VA类型预测器选择.
- 管理初始VA选择的因素的多变量逻辑回归.
- 对于中位利用时间及其预测者的Log-rank和Cox回归模型.
主要成果:
- 在68.5%的患者中,TCs启动了HD,AVFs为31.5%.
- 高龄和糖尿病是初始TC使用的预测因素.
- 初始AVF的中位时间为57.0个月,初始TC的4.99个月.
- 年轻的年龄,男性性别和高血压预测了更长时间的TC使用.
- 高龄和糖尿病预测AVF使用时间更长.
结论:
- 患者的人口统计和并发症显著影响最初的血管接入选择.
- 从临时导管过渡到永久血管接入存在显著的延迟.
- 研究结果表明,需要改进血管接入转诊和管理策略.
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