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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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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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 |
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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 |
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