کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2886014 1574207 2014 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Compliance with Surgical Follow-up Does Not Influence Fistula Maturation in a County Hospital Population
ترجمه فارسی عنوان
پیروی از پیگیری جراحی بر بلوغ فیستول در جمعیت بیمارستان شهرستان تاثیر نمی گذارد
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
چکیده انگلیسی

BackgroundThe purpose of this study is to examine follow-up rates and maturation rates after dialysis access surgery using a fistula-first approach in a county hospital with an indigent population.MethodsA prospectively maintained dialysis access database was queried for cases performed between August 1, 2009 and September 30, 2011. The follow-up period ended on December 31, 2011. An attempt was made to contact patients who did not have complete follow-up data recorded to the point of fistula maturation for arteriovenous fistulas (AVF). Patients were contacted directly or through their dialysis center. Maturation was defined by successful use of the AVF for hemodialysis for at least 2 weeks for patients who are dialysis dependent or by the clinical assessment of an attending vascular surgeon for those not on dialysis.ResultsTwo hundred three dialysis access cases were performed. The mean age was 51.4 years. One hundred twenty-six (62%) were male and 175 (86%) were Hispanic. Of these, 194 (95.6%) were AVF. Three AVF were ligated in the postoperative period for steal. Of the remaining 191 AVF, 94 (49%) patients completed their scheduled follow-up appointments. Sixty-six (35%) patients did not come to clinic but were contacted. Twenty-six (14%) patients were completely lost to follow-up and 5 (2.6%) died. Maturation data was obtained on 160 AVF. Of those, 123 (77%) reached maturation with a mean maturation time of 112 ± 99 days (range, 21–483). Twenty patients who completed follow-up underwent at least 1 additional surgical or endovascular procedure in an attempt to achieve maturation. Seventeen (85%) patients who underwent a secondary procedure went on to achieve maturation. There was no significant difference in maturation between the group that completed follow-up and those who were contacted by phone (69 [73%] vs. 54 [81%], P = not significant).ConclusionsIn this indigent population, follow-up does not influence maturation rates of AVF. Despite poor compliance with follow-up in the setting of a public hospital, the maturation rate of an aggressive fistula-first approach is acceptable.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Annals of Vascular Surgery - Volume 28, Issue 8, November 2014, Pages 1847–1852
نویسندگان
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