Impact of a preoperative evaluation on the outcomes of an arteriovenous fistula
Annals of Surgical Treatment and Research
; : 224-230, 2016.
Artigo
em Inglês
| WPRIM (Pacífico Ocidental)
| ID: wpr-39571
Biblioteca responsável:
WPRO
ABSTRACT
PURPOSE:
The aim of this study was to determine the possible predictors of primary arteriovenous fistula (AVF) failure and examine the impact of a preoperative evaluation on AVF outcomes.METHODS:
A total of 539 patients who underwent assessment for a suitable site for AVF creation by physical examination alone or additional duplex ultrasound were included in this study. Demographics, patient characteristics, and AVF outcomes were analyzed retrospectively.RESULTS:
AVF creation was proposed in 469 patients (87.0%) according to physical examination alone (351 patients) or additional duplex ultrasound (118 patients); a prosthetic arteriovenous graft was initially placed in the remaining 70 patients (13.0%). Although the primary failure rate was significantly higher in patients assessed by duplex ultrasound (P = 0.001), ultrasound information changed the clinical plan, increasing AVF use for dialysis, in 92 of the 188 patients (48.9%) with an insufficient physical examination. Female sex and diabetes mellitus were risk factors significantly associated with primary AVF failure. Because of different inclusion criteria and a lack of adjustment for baseline differences, Kaplan-Meier survival analysis showed better AVF outcomes in patients assessed by physical examination alone; an insufficient physical examination was the only risk factor significantly associated with AVF outcomes.CONCLUSION:
Routine use of duplex ultrasound is not necessary in chronic kidney disease patients with a satisfactory physical examination. Given that female gender and diabetes mellitus are significantly associated with primary AVF failure, duplex ultrasound could be of particular benefit in these subtypes of patients without a sufficient physical examination.
Texto completo:
Disponível
Base de dados:
WPRIM (Pacífico Ocidental)
Assunto principal:
Exame Físico
/
Demografia
/
Estudos Retrospectivos
/
Fatores de Risco
/
Ultrassonografia
/
Fístula Arteriovenosa
/
Diálise Renal
/
Resultado do Tratamento
/
Transplantes
/
Diabetes Mellitus
Tipo de estudo:
Estudo diagnóstico
/
Estudo de etiologia
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Aspecto:
Determinantes sociais da saúde
Limite:
Feminino
/
Humanos
Idioma:
Inglês
Revista:
Annals of Surgical Treatment and Research
Ano de publicação:
2016
Tipo de documento:
Artigo