Failure of Dialysis Access: Revise or Replace?
| Autor: | Jacob G. Robison, Bruce M. Elliott, Prabhakar Baliga, Mark Morgan, C.Thomas Fitts, Joseph B. Cofer, P.R. Rajagopolan |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Time Factors Adolescent Dialysis Access Failure Arteriovenous fistula Dialysis access Arteriovenous Shunt Surgical Renal Dialysis Blood vessel prosthesis medicine Humans In patient Child Early failure Aged Retrospective Studies Aged 80 and over business.industry Infant Retrospective cohort study Middle Aged medicine.disease Blood Vessel Prosthesis Surgery Child Preschool Access site Female business |
| Zdroj: | Journal of Surgical Research. 60:312-316 |
| ISSN: | 0022-4804 |
| Popis: | Providing adequate long-term dialysis access has become increasingly difficult. In order to evaluate the operative factors associated with early failure of dialysis access, 2337 operations performed in 1124 patients over an 8-year period were retrospectively reviewed. Evaluation of 1306 procedures that eventually failed and required operative revision or repair provided the basis for this study. Access failure occurred in 459 (41%) of the 1124 patients. An average of 2.8 episodes of failure (range 1-13) were observed among this group of patients, occurring after an average of 230 +/- 9 days (mean +/- ++standard error) postoperatively, with the longest interval to failure being 2529 days. The time-to-failure for revision of a preexistent arteriovenous fistula or prosthetic graft (140 +/- 9 days, n = 449) was significantly (P < 0.0001 ANOVA) shorter than for creation of an arteriovenous fistula (272 +/- 21 days, n = 336) or prosthetic graft (299 +/- 19 days, n = 372) at a new site. Procedures performed in octogenarians tended to fail earlier (178 days). Dialysis access failure tends to recur in patients with a history of previous access problems. The time-to-failure was similar for new prosthetic grafts and arteriovenous fistulas, but twice as long compared to revision of a previous access site. |
| Databáze: | OpenAIRE |
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