Cargando…

Prevalence and correlates of central venous catheter use among haemodialysis patients in the Irish health system - a national study

BACKGROUND: Central venous catheters (CVC) are associated with substantial morbidity and mortality among patients undergoing haemodialysis (HD), yet they are frequently used as the primary vascular access for many patients on HD. The goal of this study was to determine the prevalence and variation i...

Descripción completa

Detalles Bibliográficos
Autores principales: Hussein, Wael F., Mohammed, Husham, Browne, Leonard, Plant, Liam, Stack, Austin G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5880000/
https://www.ncbi.nlm.nih.gov/pubmed/29609535
http://dx.doi.org/10.1186/s12882-018-0873-x
_version_ 1783311098128105472
author Hussein, Wael F.
Mohammed, Husham
Browne, Leonard
Plant, Liam
Stack, Austin G.
author_facet Hussein, Wael F.
Mohammed, Husham
Browne, Leonard
Plant, Liam
Stack, Austin G.
author_sort Hussein, Wael F.
collection PubMed
description BACKGROUND: Central venous catheters (CVC) are associated with substantial morbidity and mortality among patients undergoing haemodialysis (HD), yet they are frequently used as the primary vascular access for many patients on HD. The goal of this study was to determine the prevalence and variation in CVC use across centres in the Irish health system. METHODS: Data from the National Kidney Disease Clinical Patient Management System (KDCPMS) was used to determine CVC use and patterns across centres. Data on demographic characteristics, primary cause of end-stage kidney disease (ESKD), comorbid conditions, laboratory values and centre affiliation were extracted for adult HD patients (n = 1, 196) who were on dialysis for at least three months up to end of December 2016. Correlates of CVC use were explored using multivariable logistic regression. RESULTS: Overall prevalence of CVC use was 54% and varied significantly across clinical sites from 43% to 73%, P < 0.001. In multivariate analysis, the likelihood of CVC use was lower with increasing dialysis vintage, OR 0.40 (0.26–0.60) for 4 years vs 1 year vintage, rising serum albumin, OR 0.73 (0.59–0.90) per 5 g/L), and with cystic disease as a cause of ESKD, OR 0.38 (95% CI 0.21–0.6). In contrast, catheter use was greater for women than men, OR 1.77 (1.34–2.34) and for 2 out of 10 regional dialysis centres, OR 1.98 (1.02–3.84) and OR 2.86 (1.67–4.90) respectively compared to referent group). CONCLUSIONS: Catheters are the predominant type of vascular access in patients undergoing HD in the Irish health system. Substantial centre variation exists which is not explained by patient-level characteristics. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12882-018-0873-x) contains supplementary material, which is available to authorized users.
format Online
Article
Text
id pubmed-5880000
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-58800002018-04-04 Prevalence and correlates of central venous catheter use among haemodialysis patients in the Irish health system - a national study Hussein, Wael F. Mohammed, Husham Browne, Leonard Plant, Liam Stack, Austin G. BMC Nephrol Research Article BACKGROUND: Central venous catheters (CVC) are associated with substantial morbidity and mortality among patients undergoing haemodialysis (HD), yet they are frequently used as the primary vascular access for many patients on HD. The goal of this study was to determine the prevalence and variation in CVC use across centres in the Irish health system. METHODS: Data from the National Kidney Disease Clinical Patient Management System (KDCPMS) was used to determine CVC use and patterns across centres. Data on demographic characteristics, primary cause of end-stage kidney disease (ESKD), comorbid conditions, laboratory values and centre affiliation were extracted for adult HD patients (n = 1, 196) who were on dialysis for at least three months up to end of December 2016. Correlates of CVC use were explored using multivariable logistic regression. RESULTS: Overall prevalence of CVC use was 54% and varied significantly across clinical sites from 43% to 73%, P < 0.001. In multivariate analysis, the likelihood of CVC use was lower with increasing dialysis vintage, OR 0.40 (0.26–0.60) for 4 years vs 1 year vintage, rising serum albumin, OR 0.73 (0.59–0.90) per 5 g/L), and with cystic disease as a cause of ESKD, OR 0.38 (95% CI 0.21–0.6). In contrast, catheter use was greater for women than men, OR 1.77 (1.34–2.34) and for 2 out of 10 regional dialysis centres, OR 1.98 (1.02–3.84) and OR 2.86 (1.67–4.90) respectively compared to referent group). CONCLUSIONS: Catheters are the predominant type of vascular access in patients undergoing HD in the Irish health system. Substantial centre variation exists which is not explained by patient-level characteristics. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12882-018-0873-x) contains supplementary material, which is available to authorized users. BioMed Central 2018-04-02 /pmc/articles/PMC5880000/ /pubmed/29609535 http://dx.doi.org/10.1186/s12882-018-0873-x Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Hussein, Wael F.
Mohammed, Husham
Browne, Leonard
Plant, Liam
Stack, Austin G.
Prevalence and correlates of central venous catheter use among haemodialysis patients in the Irish health system - a national study
title Prevalence and correlates of central venous catheter use among haemodialysis patients in the Irish health system - a national study
title_full Prevalence and correlates of central venous catheter use among haemodialysis patients in the Irish health system - a national study
title_fullStr Prevalence and correlates of central venous catheter use among haemodialysis patients in the Irish health system - a national study
title_full_unstemmed Prevalence and correlates of central venous catheter use among haemodialysis patients in the Irish health system - a national study
title_short Prevalence and correlates of central venous catheter use among haemodialysis patients in the Irish health system - a national study
title_sort prevalence and correlates of central venous catheter use among haemodialysis patients in the irish health system - a national study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5880000/
https://www.ncbi.nlm.nih.gov/pubmed/29609535
http://dx.doi.org/10.1186/s12882-018-0873-x
work_keys_str_mv AT husseinwaelf prevalenceandcorrelatesofcentralvenouscatheteruseamonghaemodialysispatientsintheirishhealthsystemanationalstudy
AT mohammedhusham prevalenceandcorrelatesofcentralvenouscatheteruseamonghaemodialysispatientsintheirishhealthsystemanationalstudy
AT browneleonard prevalenceandcorrelatesofcentralvenouscatheteruseamonghaemodialysispatientsintheirishhealthsystemanationalstudy
AT plantliam prevalenceandcorrelatesofcentralvenouscatheteruseamonghaemodialysispatientsintheirishhealthsystemanationalstudy
AT stackausting prevalenceandcorrelatesofcentralvenouscatheteruseamonghaemodialysispatientsintheirishhealthsystemanationalstudy