腹膜透析相关腹膜炎率-简化公式的验证

M. Marshall, Gerald P Waters, C. Verger
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引用次数: 4

摘要

腹膜炎是腹膜透析(PD)最重要的治疗相关并发症。不幸的是,世界各地的许多PD中心并没有准确地记录腹膜炎的发病率,主要是因为他们无法从“患者流”数据中确定PD患者的风险时间-即从患者开始和结束PD的日期计算PD患者的天数。我们提出了一种利用“患者存量”数据中的PD患者风险时间计算PD腹膜炎率的简化方法——即根据年初和年底在该中心流行的PD患者数量计算PD患者天数。我们比较了澳大利亚和新西兰透析和移植登记处(ANZDATA) /新西兰(NZ) PD登记处和Le register de Dialyse panalitonacale de Langue francaise et hmodialyse domicile (RDPLF)的年度PD腹膜炎发生率的金标准测量值与简化的测量值。共有来自9个国家的268个中心,随访4311个中心年和110,185个患者年。总体一致性非常好,ANZDATA / NZ PD Registry的一致性相关系数为0.978(95%可信区间[CI] 0.975-0.980), RDPLF的一致性相关系数为0.978(0.977-0.980)。尽管简化公式在这些中心的临床表现仍然良好,但在注册中心中,较小的中心的一致性分别为0.972(0.966-0.976)和0.973(0.970-0.976),具有统计学意义。计算PD腹膜炎率的简化方法是准确的,并将允许世界上更多的中心测量,报告和减少PD腹膜炎率的工作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Peritoneal Dialysis Associated Peritonitis Rate – Validation of a Simplified Formula
Peritonitis is the most important therapy-related complication of peritoneal dialysis (PD). Unfortunately, many PD centers around the world do not accurately record peritonitis rate, mainly because they cannot ascertain PD patient time-at-risk from “patient flow” data - that is, calculating PD patient-days from dates when patients start and finish PD. We propose a simplified method of calculating PD peritonitis rate using PD patient time-at-risk from “patient stock” data - - that is, calculating PD patient-days from the number of prevalent PD patients at the center at the start of the year and the corresponding number at the end. We compared gold-standard measurements of annual PD peritonitis rates with simplified ones in the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) / New Zealand (NZ) PD Registry, and Le Registre de Dialyse Péritonéale de Langue Française et hémodialyse à domicile (the RDPLF). A total of 268 centers from 9 countries with 4311 center-years and 110,185 patient-years of follow-up were modelled. Overall agreement was excellent with a concordance correlation coefficient of 0.978 (95% confidence interval [CI] 0.975-0.980) in ANZDATA / NZ PD Registry, and 0.978 (0.977-0.980) in the RDPLF. There was statistically significant lower agreement for smaller centers in the registries at 0.972 (0.966-0.976) and 0.973 (0.970-0.976) respectively, although the performance of the simplified formula remains clinically sound in even these centers. The simplified method of calculating PD peritonitis rate is accurate, and will allow more centers around the world to measure, report, and work on reducing PD peritonitis rates.
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