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Risk factors for blood vessel rupture during vascular access intervention therapy for hemodialysis patients

Blood vessel rupture is a major complication associated with vascular access intervention therapy (VAIVT). However, information regarding the risk factors for ruptures related to VAIVT is limited. The purpose of this study was to investigate the risk factors for rupture during VAIVT. This was a sing...

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Autores principales: Kambayashi, Yui, Iseri, Ken, Morikawa, Tomoki, Yao, Atushi, Yokochi, Akio, Honda, Hirokazu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10065258/
https://www.ncbi.nlm.nih.gov/pubmed/37000893
http://dx.doi.org/10.1371/journal.pone.0283844
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author Kambayashi, Yui
Iseri, Ken
Morikawa, Tomoki
Yao, Atushi
Yokochi, Akio
Honda, Hirokazu
author_facet Kambayashi, Yui
Iseri, Ken
Morikawa, Tomoki
Yao, Atushi
Yokochi, Akio
Honda, Hirokazu
author_sort Kambayashi, Yui
collection PubMed
description Blood vessel rupture is a major complication associated with vascular access intervention therapy (VAIVT). However, information regarding the risk factors for ruptures related to VAIVT is limited. The purpose of this study was to investigate the risk factors for rupture during VAIVT. This was a single-center, retrospective observational study. Demographic, clinical, anatomical, and VAIVT procedure variables were reviewed and analyzed using multivariate logistic regression. The 211 patients included in the study underwent 628 VAIVT procedures from November 2019 to December 2021, and 20 blood vessel ruptures occurred. Patients with ruptures had significantly lower BMI (p = 0.043), shorter access vintage(p = 0.017), underwent VAIVT for the first time (p = 0.006), and had lower blood flow quantity (p = 0.005), lower brachial artery flow volume (p = 0.018), and higher resistance index (p = 0.011). The multivariate logistic regression revealed that receiving VAIVT for the first time (OR 5.95, 95%CI 1.01–34.84; p = 0.048) and high resistance index (OR 1.86, 95%CI 1.01–3.16; p = 0.02) were significantly associated with a high risk for rupture. Furthermore, receiver operating characteristic curve analysis to assess the sensitivity-specificity profiles of the resistance index for ruptures showed that the optimal threshold was 0.70 (sensitivity/specificity, 0.69/0.70). Heightened surveillance during vascular access intervention therapy is warranted, especially in patients undergoing VAIVT for the first time or patients with a high resistance index (> 0.70).
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spelling pubmed-100652582023-04-01 Risk factors for blood vessel rupture during vascular access intervention therapy for hemodialysis patients Kambayashi, Yui Iseri, Ken Morikawa, Tomoki Yao, Atushi Yokochi, Akio Honda, Hirokazu PLoS One Research Article Blood vessel rupture is a major complication associated with vascular access intervention therapy (VAIVT). However, information regarding the risk factors for ruptures related to VAIVT is limited. The purpose of this study was to investigate the risk factors for rupture during VAIVT. This was a single-center, retrospective observational study. Demographic, clinical, anatomical, and VAIVT procedure variables were reviewed and analyzed using multivariate logistic regression. The 211 patients included in the study underwent 628 VAIVT procedures from November 2019 to December 2021, and 20 blood vessel ruptures occurred. Patients with ruptures had significantly lower BMI (p = 0.043), shorter access vintage(p = 0.017), underwent VAIVT for the first time (p = 0.006), and had lower blood flow quantity (p = 0.005), lower brachial artery flow volume (p = 0.018), and higher resistance index (p = 0.011). The multivariate logistic regression revealed that receiving VAIVT for the first time (OR 5.95, 95%CI 1.01–34.84; p = 0.048) and high resistance index (OR 1.86, 95%CI 1.01–3.16; p = 0.02) were significantly associated with a high risk for rupture. Furthermore, receiver operating characteristic curve analysis to assess the sensitivity-specificity profiles of the resistance index for ruptures showed that the optimal threshold was 0.70 (sensitivity/specificity, 0.69/0.70). Heightened surveillance during vascular access intervention therapy is warranted, especially in patients undergoing VAIVT for the first time or patients with a high resistance index (> 0.70). Public Library of Science 2023-03-31 /pmc/articles/PMC10065258/ /pubmed/37000893 http://dx.doi.org/10.1371/journal.pone.0283844 Text en © 2023 Kambayashi et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Kambayashi, Yui
Iseri, Ken
Morikawa, Tomoki
Yao, Atushi
Yokochi, Akio
Honda, Hirokazu
Risk factors for blood vessel rupture during vascular access intervention therapy for hemodialysis patients
title Risk factors for blood vessel rupture during vascular access intervention therapy for hemodialysis patients
title_full Risk factors for blood vessel rupture during vascular access intervention therapy for hemodialysis patients
title_fullStr Risk factors for blood vessel rupture during vascular access intervention therapy for hemodialysis patients
title_full_unstemmed Risk factors for blood vessel rupture during vascular access intervention therapy for hemodialysis patients
title_short Risk factors for blood vessel rupture during vascular access intervention therapy for hemodialysis patients
title_sort risk factors for blood vessel rupture during vascular access intervention therapy for hemodialysis patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10065258/
https://www.ncbi.nlm.nih.gov/pubmed/37000893
http://dx.doi.org/10.1371/journal.pone.0283844
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