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Replacement tunnelled dialysis catheters for haemodialysis access: Same site, new site, or exchange - a multivariate analysis and risk score.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Tapping, C. R. Scott, P. M. Lakshminarayan, R. Ettles, D. F. Robinson, G. J.
Description	Country affiliation: United kingdom Author Affiliation: Tapping CR ( Department of Radiology, Hull Royal Infirmary, UK.)
Abstract	AIM: To identify variables related to complications following tunnelled dialysis catheter (TDC) replacement and stratifying the risk to reduce morbidity in patients with end-stage renal disease. MATERIALS AND METHODS: One hundred and forty TDCs (Split Cath, medCOMP) were replaced in 140 patients over a 5 year period. Multiple variables were retrospectively collected and analysed to stratify the risk and to predict patients who were more likely to suffer from complications. Multivariate regression analysis was used to identify variables predictive of complications. RESULTS: There were six immediate complications, 42 early complications, and 37 late complications. Multivariate analysis revealed that variables significantly associated to complications were: female sex (p = 0.003; OR 2.9); previous TDC in the same anatomical position in the past (p = 0.014; OR 4.1); catheter exchange (p = 0.038; OR 3.8); haemoglobin <11 g/dl (p = 0.033; OR 3.6); albumin <30 g/l (p = 0.007; OR 4.4); prothrombin time >15 s (p = 0.002; OR 4.1); and C-reactive protein >50 mg/l (p = 0.007; OR 4.6). A high-risk score, which used the values from the multivariate analysis, predicted 100% of the immediate complications, 95% of the early complications, and 68% of the late complications. CONCLUSION: Patients can now be scored prior to TDC replacement. A patient with a high-risk score can be optimized to reduce the chance of complications. Further prospective studies to confirm that rotating the site of TDC reduces complications are warranted as this has implications for current guidelines.
File Format	HTM / HTML
ISSN	00099260
Issue Number	10
Volume Number	67
e-ISSN	1365229X
Journal	Clinical Radiology
Language	English
Publisher	Elsevier
Publisher Date	2012-10-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Radiology Catheterization, Peripheral Statistics & Numerical Data Catheters, Indwelling Kidney Failure, Chronic Epidemiology Rehabilitation Prosthesis-related Infections Renal Dialysis Adult Aged Aged, 80 And Over Comorbidity Device Removal Equipment Failure Female Humans Male Middle Aged Multivariate Analysis Prevalence Reoperation Risk Assessment Sex Distribution Treatment Outcome Great Britain Clinical Trial Journal Article
Content Type	Text
Resource Type	Article
Subject	Radiology, Nuclear Medicine and Imaging

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Replacement tunnelled dialysis catheters for haemodialysis access: Same site, new site, or exchange - a multivariate analysis and risk score.