RESUMO
According to National Institute of Clinical Excellence guidelines, the ankle-brachial pressure index coupled with a full clinical evaluation has been the mainstay of detecting peripheral arterial disease on its suspicion. However, this technique is not free of its own limitations in calcified arteries, ulcerative and diabetic patients. We introduce a new, novel, and effective assessment device (BlueDop) with a minimal learning curve that could overcome such barriers and serve as a valid replacement in perihospital settings.
Assuntos
Determinação da Pressão Arterial/instrumentação , Determinação da Pressão Arterial/métodos , Doença Arterial Periférica/diagnóstico , Ultrassonografia Doppler/instrumentação , Ultrassonografia Doppler/métodos , Idoso , Idoso de 80 Anos ou mais , Índice Tornozelo-Braço/métodos , Estudos de Coortes , Feminino , Humanos , Extremidade Inferior/fisiopatologia , Masculino , Reprodutibilidade dos TestesRESUMO
PURPOSE: The aim of this study is to test the null hypothesis that preoperative albumin along with other preoperative confounders have no impact on the functional maturation of radiocephalic arteriovenous fistulae (RCAVF). METHODS: A retrospective cohort study of n = 195 individuals undergoing RCAVF formation from July 2013 to December 2015 was conducted. The null hypothesis was assessed through chi squared test. Independent association of each variable was evaluated through univariate and multivariate logistic regression model. Pearson's correlation test was also performed between scale variables to establish their causal link. RESULTS: Preoperative hypoalbuminaemic group of individuals demonstrated significant failure of maturation (49.3% vs. 27.2%, p = 0.002). At multivariate analysis, hypoalbuminemia remained an independent marker of fistula failure (OR 0.40, 95% CI 0.21-0.76, p = 0.004) and demonstrated a weak but a positive correlation at the endpoint of maturation (R = 0.223, p = 0.002). CONCLUSIONS: Preoperative hypoalbuminemia (<35 mg/dL) is independently associated with 40% reduction in the functional maturation of RCAVF. Stratification of this readily available biomarker prior to RCAVF formation may require consideration subjected to further research.
