{"title":"评估血液透析导管相关手术后出血的相关因素以及使用抗血小板药物的风险。","authors":"Sreekanth Koduri, Gareth Yeow Keng Chionh, Jien-Yi Khaw, Shaohui Foong, Chang Yin Chionh","doi":"10.1177/11297298231190113","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Bleeding is a potential complication following haemodialysis catheter-related procedures. Besides uraemia, bleeding risk is perceived to be even higher in patients receiving antiplatelets. This study aims to evaluate the risk factors for bleeding following dialysis catheter-related procedures.</p><p><strong>Methods: </strong>This is a secondary analysis of a single-centre, prospective cohort study between March 2019 and June 2020. Potential risk factors for bleeding were collected, including use of antiplatelets and anticoagulants, serum urea and haematological results. Patients were observed closely for external bleeding following haemodialysis catheter-related procedures.</p><p><strong>Results: </strong>From 413 patients screened, 250 were recruited. Of these, 177 underwent dialysis catheter insertion (157 tunnelled and 20 non-tunnelled) while 73 had dialysis catheter removed (35 tunnelled and 38 non-tunnelled). One hundred and four patients (41.6%) were on a single anti-platelet agent, of whom 75 (30.0%) were on aspirin and 29 (11.6%) had clopidogrel alone. Twenty-nine patients (11.6%) were on both aspirin and clopidogrel.There were 36 episodes (14.4%) of bleeding. The risk of bleeding was not significantly higher with the use of aspirin alone (odds ratio = 0.85, 95% CI: 0.36-2.02, <i>p</i> = 0.709), clopidogrel alone (odds ratio = 1.04, 95% CI: 0.31-3.49, <i>p</i> = 0.953) and both aspirin and clopidogrel (odds ratio = 0.95, 95% CI: 0.28-3.25, <i>p</i> = 0.938). In a multivariate analysis, none of the known bleeding risk factors had a statistically significant association with bleeding.</p><p><strong>Conclusions: </strong>Overall, the use of antiplatelet agents was not associated with an increased risk of bleeding.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"1842-1847"},"PeriodicalIF":1.6000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluation of factors associated with bleeding following haemodialysis catheter-related procedures and the risk with anti-platelet agents.\",\"authors\":\"Sreekanth Koduri, Gareth Yeow Keng Chionh, Jien-Yi Khaw, Shaohui Foong, Chang Yin Chionh\",\"doi\":\"10.1177/11297298231190113\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Bleeding is a potential complication following haemodialysis catheter-related procedures. Besides uraemia, bleeding risk is perceived to be even higher in patients receiving antiplatelets. This study aims to evaluate the risk factors for bleeding following dialysis catheter-related procedures.</p><p><strong>Methods: </strong>This is a secondary analysis of a single-centre, prospective cohort study between March 2019 and June 2020. Potential risk factors for bleeding were collected, including use of antiplatelets and anticoagulants, serum urea and haematological results. Patients were observed closely for external bleeding following haemodialysis catheter-related procedures.</p><p><strong>Results: </strong>From 413 patients screened, 250 were recruited. Of these, 177 underwent dialysis catheter insertion (157 tunnelled and 20 non-tunnelled) while 73 had dialysis catheter removed (35 tunnelled and 38 non-tunnelled). One hundred and four patients (41.6%) were on a single anti-platelet agent, of whom 75 (30.0%) were on aspirin and 29 (11.6%) had clopidogrel alone. Twenty-nine patients (11.6%) were on both aspirin and clopidogrel.There were 36 episodes (14.4%) of bleeding. The risk of bleeding was not significantly higher with the use of aspirin alone (odds ratio = 0.85, 95% CI: 0.36-2.02, <i>p</i> = 0.709), clopidogrel alone (odds ratio = 1.04, 95% CI: 0.31-3.49, <i>p</i> = 0.953) and both aspirin and clopidogrel (odds ratio = 0.95, 95% CI: 0.28-3.25, <i>p</i> = 0.938). In a multivariate analysis, none of the known bleeding risk factors had a statistically significant association with bleeding.</p><p><strong>Conclusions: </strong>Overall, the use of antiplatelet agents was not associated with an increased risk of bleeding.</p>\",\"PeriodicalId\":56113,\"journal\":{\"name\":\"Journal of Vascular Access\",\"volume\":\" \",\"pages\":\"1842-1847\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Vascular Access\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/11297298231190113\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/8/1 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Vascular Access","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/11297298231190113","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/8/1 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
Evaluation of factors associated with bleeding following haemodialysis catheter-related procedures and the risk with anti-platelet agents.
Background: Bleeding is a potential complication following haemodialysis catheter-related procedures. Besides uraemia, bleeding risk is perceived to be even higher in patients receiving antiplatelets. This study aims to evaluate the risk factors for bleeding following dialysis catheter-related procedures.
Methods: This is a secondary analysis of a single-centre, prospective cohort study between March 2019 and June 2020. Potential risk factors for bleeding were collected, including use of antiplatelets and anticoagulants, serum urea and haematological results. Patients were observed closely for external bleeding following haemodialysis catheter-related procedures.
Results: From 413 patients screened, 250 were recruited. Of these, 177 underwent dialysis catheter insertion (157 tunnelled and 20 non-tunnelled) while 73 had dialysis catheter removed (35 tunnelled and 38 non-tunnelled). One hundred and four patients (41.6%) were on a single anti-platelet agent, of whom 75 (30.0%) were on aspirin and 29 (11.6%) had clopidogrel alone. Twenty-nine patients (11.6%) were on both aspirin and clopidogrel.There were 36 episodes (14.4%) of bleeding. The risk of bleeding was not significantly higher with the use of aspirin alone (odds ratio = 0.85, 95% CI: 0.36-2.02, p = 0.709), clopidogrel alone (odds ratio = 1.04, 95% CI: 0.31-3.49, p = 0.953) and both aspirin and clopidogrel (odds ratio = 0.95, 95% CI: 0.28-3.25, p = 0.938). In a multivariate analysis, none of the known bleeding risk factors had a statistically significant association with bleeding.
Conclusions: Overall, the use of antiplatelet agents was not associated with an increased risk of bleeding.
期刊介绍:
The Journal of Vascular Access (JVA) is issued six times per year; it considers the publication of original manuscripts dealing with clinical and laboratory investigations in the fast growing field of vascular access. In addition reviews, case reports and clinical trials are welcome, as well as papers dedicated to more practical aspects covering new devices and techniques.
All contributions, coming from all over the world, undergo the peer-review process.
The Journal of Vascular Access is divided into independent sections, each led by Editors of the highest scientific level:
• Dialysis
• Oncology
• Interventional radiology
• Nutrition
• Nursing
• Intensive care
Correspondence related to published papers is also welcome.