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。

IF 1.6 3区 医学 Q3 PERIPHERAL VASCULAR DISEASE
Journal of Vascular Access Pub Date : 2024-11-01 Epub Date: 2023-08-01 DOI:10.1177/11297298231190113
Sreekanth Koduri, Gareth Yeow Keng Chionh, Jien-Yi Khaw, Shaohui Foong, Chang Yin Chionh
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引用次数: 0

摘要

背景:出血是血液透析导管相关手术后的潜在并发症。除尿毒症外,接受抗血小板治疗的患者出血风险更高。本研究旨在评估透析导管相关手术后出血的风险因素:本研究是对 2019 年 3 月至 2020 年 6 月期间一项单中心前瞻性队列研究的二次分析。收集了出血的潜在风险因素,包括抗血小板和抗凝剂的使用、血清尿素和血液学结果。密切观察患者在血液透析导管相关手术后的外伤出血情况:从筛选出的 413 名患者中,招募了 250 人。其中,177 名患者进行了透析导管插入手术(157 名为隧道式,20 名为非隧道式),73 名患者拔除了透析导管(35 名为隧道式,38 名为非隧道式)。144 名患者(41.6%)使用单一抗血小板药物,其中 75 人(30.0%)使用阿司匹林,29 人(11.6%)仅使用氯吡格雷。29名患者(11.6%)同时服用阿司匹林和氯吡格雷。单独使用阿司匹林(几率比=0.85,95% CI:0.36-2.02,p=0.709)、单独使用氯吡格雷(几率比=1.04,95% CI:0.31-3.49,p=0.953)以及同时使用阿司匹林和氯吡格雷(几率比=0.95,95% CI:0.28-3.25,p=0.938),出血风险并没有明显增加。在多变量分析中,所有已知的出血风险因素均与出血无显著统计学关联:总体而言,使用抗血小板药物与出血风险增加无关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

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来源期刊
Journal of Vascular Access
Journal of Vascular Access 医学-外周血管病
CiteScore
3.40
自引率
31.60%
发文量
181
审稿时长
6-12 weeks
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.
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