Outcomes of a nephrologist-driven tunnelled dialysis catheter insertion service in South East Asia
| Autor: | Ying Ying Seow, Claude J. Renaud, Allen Yan Lun Liu, Sri Fairuz B. Saifful, Joshua Shaowen Lee, Milind Nikam, Lee Ying Yeoh, Eng Kuang Lim |
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| Rok vydání: | 2017 |
| Předmět: |
Nephrology
Male medicine.medical_specialty Catheterization Central Venous Time Factors 030232 urology & nephrology Vascular access Bacteremia Kaplan-Meier Estimate 030218 nuclear medicine & medical imaging Nephrologists 03 medical and health sciences Dialysis access 0302 clinical medicine Catheters Indwelling Sex Factors Renal Dialysis Risk Factors Internal medicine Medicine Central Venous Catheters Humans South east asia Intensive care medicine Device Removal Aged Proportional Hazards Models Singapore business.industry Process Assessment Health Care Dialysis catheter Middle Aged Catheter-Related Infections Equipment failure Treatment Outcome Multivariate Analysis Surgery Equipment Failure Female business Dialysis (biochemistry) |
| Zdroj: | The journal of vascular access. 18(4) |
| ISSN: | 1724-6032 |
| Popis: | Introduction: Tunnelled dialysis catheters (TDCs) are being increasingly inserted by nephrologists globally but there is limited experience and paucity of published outcomes data from South-East Asia (SEA). This study was conducted to analyse the outcomes of TDC insertion by nephrologists from a single centre in SEA. Methods All patients who underwent TDC insertion by nephrologists from October 2013 to June 2016 were included. TDC survival was calculated using Kaplan-Meier survival method. Impact of variables was assessed using Cox proportional hazards model. Results A total of 344 TDCs were inserted in 274 patients. The most common indication was haemodialysis initiation (60.2%) followed by existing catheter dysfunction (CD) (12.2%), failed vascular access (10.2%) and catheter-related bacteraemia (CRB) (9.9%). Insertion was successful in 97% patients. The most common location was the right internal jugular vein (87%). The cumulative survival for all TDCs inserted, as defined by the time to non-elective removal of a TDC, at 3, 6 and 9 months was 83%, 61%, and 44%, respectively. Median catheter survival was 231 days. Common indications for removal were CD (13.4%) and CRB or suspected infection (12.5%). Common complications were bleeding (8.72%), infection (13.7%) and CD (16.5%). Median time to infection was 103 days. In multivariate analysis, male gender was associated with poor catheter survival, for primary insertions (p = 0.015, HR 0.62) and diabetes was associated with TDC infection (p = 0.024, OR 1.1). Conclusions This is one of the first reports of TDC insertion by nephrologists from SEA. Our outcomes compare favourably with those reported in the literature. |
| Databáze: | OpenAIRE |
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