Correlation of Mortality and Location of Arteriovenous Fistula in Hemodialysis Patients
Purpose Since the type of vascular access is very important and a significant risk factor for mortality in patients on hemodialysis, the aim of our study was to determine the impact of AVF positioning on the mortality of our patients. Methods The survey was organized as a prospective, clinical and n...
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Published in: | International journal of artificial organs Vol. 34; no. 1; pp. 26 - 33 |
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Main Authors: | , , , , |
Format: | Journal Article |
Language: | English |
Published: |
London, England
SAGE Publications
01-01-2011
Wichtig |
Subjects: | |
Online Access: | Get full text |
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Summary: | Purpose
Since the type of vascular access is very important and a significant risk factor for mortality in patients on hemodialysis, the aim of our study was to determine the impact of AVF positioning on the mortality of our patients.
Methods
The survey was organized as a prospective, clinical and non-randomized study of 538 surgical interventions on 323 patients, which indicates that a large number of patients had more than one fistula. Among these patients, 120 subjects (81 (67.5%) men and 39 (32.5%) women) died during the study period. We analyzed the demographic structure, the site location and type of anastomosis for the arteriovenous fistula, artery and vein lumen and presence of instillation catheters, as well as measuring flow through the fistula and arterial blood pressure. Biochemical parameters thought to have a significant impact on survival were obtained from routine monthly analyses.
Results
In patients in whom infection was the cause of death, termino-terminal anastomosis was more frequently present (p=0.035). Variables that were statistically significant predictors of death were elderly individuals (Beta 0.033, p<0.001); patients whose diastolic blood pressure was low (Beta –0.028, p<0.001); and the position of the arteriovenous fistula (distal Beta –0.737, p=0.001; proximal Beta –0.581, p=0.008). Patients with a cubital fistula (p=0.001) had a significantly shorter Kaplan-Meier survival curve.
Conclusions
End-to-end artery and vein connection was a significantly more common form of anastomosis in patients who died as a result of infection. Important parameters of mortality in our study were the position of the arteriovenous fistula, age, and the diastolic component of arterial blood pressure. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1 |
ISSN: | 0391-3988 1724-6040 |
DOI: | 10.5301/IJAO.2011.6311 |