MANAGEMENT OF VASCULAR ACCESS IN EUROPE: PART 2 - A MULTI CENTRE STUDY OF RELATED COMPLICATIONS
作者:Monique M. Elseviers、Jean-Pierre Waeleghem、Elizabeth Lindley
DOI:10.1111/j.1755-6686.2003.tb00272.x
日期:2003.1.3
SUMMARYIntroduction | The pilot project of the Research Board of EDTNA/ERCA handled the management of vascular accesses (VA) in European dialysis centres. In the first part of the study, centre policies related to VA management were investigated. This paper reports on the second part of the project, investigating VA related complications reported during an observational prospective study.Methods | A cohort of 1380 adult patients, randomly selected in 47 centres out of 16 European countries were followed during one year using a computerised data collection system. Data were collected at baseline, after six and 12 months and each time a VA complication occurred.Results | At the start of the observation period, 77% had a native AV fistula, 10% had an AV graft and 13% a catheter. A total of 489 complications were noted. Most frequently observed were thrombosis, stenosis, infection, bleeding and flow problems. Hospitalisation (mean duration=6.2 days) was required in 39% of complications and 29% of complications resulted in a definitive loss of VA. Complications were more frequently observed in catheters (27%) and AV grafts (37%) compared to AV fistulae (15%). When compared with AV fistulae, the risk for thrombosis was more than four times higher and for bleeding more than six times higher if an AV graft was used. Catheters showed an eightfold increased risk to develop infections and flow problems.Conclusion | This study revealed the high complication rate in VA and strengthened the actions to promote AV fistulae as first choice VA.