亲爱的研友该休息了!由于当前在线用户较少,发布求助请尽量完整地填写文献信息,科研通机器人24小时在线,伴您度过漫漫科研夜!身体可是革命的本钱,早点休息,好梦!

Complications From Tunneled Hemodialysis Catheters: A Canadian Observational Cohort Study

医学 血液透析 观察研究 队列研究 重症监护医学 队列 外科 血液透析导管 内科学
作者
Krishna Poinen,Robert R. Quinn,Alix Clarke,Pietro Ravani,Swapnil Hiremath,Lisa Miller,Peter G. Blake,Matthew J. Oliver
出处
期刊:American Journal of Kidney Diseases [Elsevier BV]
卷期号:73 (4): 467-475 被引量:110
标识
DOI:10.1053/j.ajkd.2018.10.014
摘要

Rationale & Objective Clinical practice guidelines discourage the use of central venous catheters (CVCs) for vascular access in dialysis. However, some patients have inadequate vessels for arteriovenous fistula creation or choose to use a dialysis catheter. The risks associated with CVC use and their relationship to patient age are poorly characterized. Study Design Observational retrospective cohort study. Setting & Participants Cohort of 1,041 patients older than 18 years from 5 Canadian dialysis programs who initiated outpatient maintenance hemodialysis therapy with a tunneled CVC between 2004 and 2012 and who had no creation of an arteriovenous fistula or arteriovenous graft. Exposures Age, sex, body size, initiating dialysis therapy in the hospital, and comorbid conditions. Outcomes CVC-related procedures, hospitalization, and death. Analytical Approach Complications were reported as a cumulative risk at 1 and 2 years. Cox proportional hazards regression for recurrent events was used to evaluate risk factors for study outcomes. Results At 1 year, risks for CVC-related bacteremia, malfunction, and central stenosis were 9%, 15%, and 2%, respectively. Risks for any CVC-related complication at 1 and 2 years were 30% and 38%, respectively. Death related to CVC complications occurred in 6 of 1,041 (0.5%) patients. Compared with patients younger than 60 years, patients aged 70 to 79 and those 80 years or older experienced lower rates of CVC complications: HRs of 0.67 (95% CI, 0.52-0.85; P = 0.001) and 0.69 (95% CI, 0.52-0.92; P = 0.01), respectively. Limitations This Canadian dialysis population may not be representative of populations in other countries. CVC use was not compared with other types of hemodialysis vascular access. Conclusions Approximately one-third of hemodialysis patients who used tunneled CVCs during 1 to 2 years experienced complications. Bacteremia occurred in ∼9% of patients at 1 year and were the most common cause of CVC-related hospitalizations. CVC-related death was infrequent. This information could be used to communicate the risk for CVC complications to patients treated with this type of hemodialysis vascular access. Clinical practice guidelines discourage the use of central venous catheters (CVCs) for vascular access in dialysis. However, some patients have inadequate vessels for arteriovenous fistula creation or choose to use a dialysis catheter. The risks associated with CVC use and their relationship to patient age are poorly characterized. Observational retrospective cohort study. Cohort of 1,041 patients older than 18 years from 5 Canadian dialysis programs who initiated outpatient maintenance hemodialysis therapy with a tunneled CVC between 2004 and 2012 and who had no creation of an arteriovenous fistula or arteriovenous graft. Age, sex, body size, initiating dialysis therapy in the hospital, and comorbid conditions. CVC-related procedures, hospitalization, and death. Complications were reported as a cumulative risk at 1 and 2 years. Cox proportional hazards regression for recurrent events was used to evaluate risk factors for study outcomes. At 1 year, risks for CVC-related bacteremia, malfunction, and central stenosis were 9%, 15%, and 2%, respectively. Risks for any CVC-related complication at 1 and 2 years were 30% and 38%, respectively. Death related to CVC complications occurred in 6 of 1,041 (0.5%) patients. Compared with patients younger than 60 years, patients aged 70 to 79 and those 80 years or older experienced lower rates of CVC complications: HRs of 0.67 (95% CI, 0.52-0.85; P = 0.001) and 0.69 (95% CI, 0.52-0.92; P = 0.01), respectively. This Canadian dialysis population may not be representative of populations in other countries. CVC use was not compared with other types of hemodialysis vascular access. Approximately one-third of hemodialysis patients who used tunneled CVCs during 1 to 2 years experienced complications. Bacteremia occurred in ∼9% of patients at 1 year and were the most common cause of CVC-related hospitalizations. CVC-related death was infrequent. This information could be used to communicate the risk for CVC complications to patients treated with this type of hemodialysis vascular access.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
obedVL完成签到,获得积分10
27秒前
cqhecq完成签到,获得积分10
38秒前
1分钟前
1分钟前
1分钟前
1分钟前
汉德萌多林完成签到,获得积分10
1分钟前
1分钟前
李文华发布了新的文献求助20
1分钟前
两个轮完成签到 ,获得积分10
1分钟前
2分钟前
汪鸡毛完成签到 ,获得积分10
2分钟前
rachel发布了新的文献求助10
2分钟前
CodeCraft应助敏感的从露采纳,获得10
2分钟前
华仔应助大气的夏云采纳,获得20
2分钟前
2分钟前
李文华完成签到,获得积分20
3分钟前
活泼绝山应助李文华采纳,获得60
3分钟前
孤独的大灰狼完成签到 ,获得积分10
3分钟前
3分钟前
John完成签到,获得积分10
3分钟前
王冠军发布了新的文献求助10
3分钟前
彭于晏应助大司马采纳,获得10
3分钟前
3分钟前
王冠军完成签到,获得积分10
3分钟前
handsomeboy发布了新的文献求助100
3分钟前
handsomeboy完成签到,获得积分10
4分钟前
一二一发布了新的文献求助10
4分钟前
4分钟前
4分钟前
大司马发布了新的文献求助10
4分钟前
成就的向松完成签到 ,获得积分10
4分钟前
4分钟前
大司马完成签到,获得积分10
4分钟前
敏感的从露关注了科研通微信公众号
4分钟前
4分钟前
我是老大应助Geralt采纳,获得10
4分钟前
4分钟前
不懈奋进应助herococa采纳,获得30
4分钟前
5分钟前
高分求助中
Africanfuturism: African Imaginings of Other Times, Spaces, and Worlds 3000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 2000
Electron microscopy study of magnesium hydride (MgH2) for Hydrogen Storage 1000
Learning to Listen, Listening to Learn: Music Perception and the Psychology of Enculturation 700
Structural Equation Modeling of Multiple Rater Data 700
全球膝关节骨性关节炎市场研究报告 555
Exhibiting Chinese Art in Asia: Histories, Politics and Practices 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 物理 生物化学 纳米技术 计算机科学 化学工程 内科学 复合材料 物理化学 电极 遗传学 量子力学 基因 冶金 催化作用
热门帖子
关注 科研通微信公众号,转发送积分 3894932
求助须知:如何正确求助?哪些是违规求助? 3438683
关于积分的说明 10808104
捐赠科研通 3163628
什么是DOI,文献DOI怎么找? 1747668
邀请新用户注册赠送积分活动 844085
科研通“疑难数据库(出版商)”最低求助积分说明 787809