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Vascular access care accounts for a third of ESRD cost and is a leading cause of morbidity in hemodialysis (HD) patients. We designed this study to identify the risk factors for vascular access infection and to determine the cost of related hospitalizations. Methods: All HD patients at DCI Oakland from 1/1/99 to 6/30/02 were prospectively studied for access type, infections (Infx) including bacteremia, exit site, tunnel or cellulitis, and related hospitalizations. Cost data was obtained from the inpatient electronic medical record system. Risk factors for infection were evaluated using Poisson regression analysis, and cost comparison was done using ANOVA. Results: 153 patients were included in the analysis and were grouped by type of access: temporary catheter (TC) n = 84, permanent/tunneled catheter (PC) n = 158, AV graft (AVG) n = 87 and AV fistula (AVF) n = 57. Univariate analysis revealed significant risk factors to be female gender (p = 0.004, RR = 1.85) and type of access. In multivariate analysis, compared to AVF, risk of infection was highest with TC (p |
