介入放射科医师插入隧道式腹膜透析导管后的结果和危险因素。

IF 2.6 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE
Rithvik Karthikeyan, Ileesha Singh, Satvik Hadigal, Daniel Picus, Naganathan Mani
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引用次数: 0

摘要

目的:评估患者因素,包括年龄、性别和糖尿病患者是否与介入放射学放置隧道腹膜透析(PD)导管过程中的不良事件相关。材料和方法:本回顾性队列研究调查了2021年7月至2024年5月期间在一家学术教学医院的介入放射学团队进行的需要肾脏置换并首次行隧道PD导管置入手术的患者(n=104)。PD过程中的不良事件定义为首次腹膜炎、导管功能障碍、导管不全、导管不耐受或死亡。推断分析包括逻辑回归和Cox比例风险模型来评估潜在的危险因素。结果:在纳入的患者中,32例(30.8%)在PD病程中至少经历一次腹膜炎发作,其中6例经历多次发作。糖尿病患者的风险比最高,为1.59,CI 0.92-2.75, p =0.094,提示与不良事件的发生存在潜在关联。葡萄球菌感染在迟发性腹膜炎(LOP)中更为常见(p =0.03)。结论:腹膜炎仍然是腹膜透析的主要并发症,尽管目前的最佳做法。此外,基于发病时间的致病生物的差异值得进一步关注,特别是在其管理和经验性抗生素方面。糖尿病患者在导管插入过程中发生不良事件的风险也很大。更深入地了解PD的复杂性对于获得更好的临床结果至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Outcomes and Risk Factors Following Tunneled Peritoneal Dialysis Catheter Insertion by Interventional Radiologists.

Purpose: To assess whether patient factors, including age, sex, and diabetic involvement, are associated with adverse events during the course of tunneled peritoneal dialysis (PD) catheter placed by Interventional Radiology.

Materials and methods: This retrospective cohort study examines patients (n=104) who required kidney replacement and underwent their initial tunneled PD catheter insertion procedure by the interventional radiology team at an academic teaching hospital between July 2021 and May 2024. An adverse event during the course of PD was defined as the first episode of peritonitis, catheter dysfunction, catheter insufficiency, catheter intolerance, or death. Inferential analyses included logistic regression and Cox proportional hazards models to assess potential risk factors.

Results: Of the included patients, 32 (30.8%) experienced at least one episode of peritonitis during their PD course, with six patients experiencing multiple episodes. Diabetic involvement had the highest hazard ratio of 1.59, CI 0.92-2.75, p =0.094, suggesting a potential association with the occurrence of adverse events. Staphylococcus infections appeared to be more common in late-onset peritonitis (LOP) (p =0.03).

Conclusion: Peritonitis remains a major complication of PD despite current best practices. Moreover, the differences in the causative organism based on the time of episode warrant further attention, especially in terms of its management and empiric antibiotics. Diabetic involvement also remains a significant risk for the occurrence of an adverse event in the course of the inserted catheter. A deeper understanding of the complexities associated with PD is essential to achieving better clinical outcomes.

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来源期刊
CiteScore
4.30
自引率
10.30%
发文量
942
审稿时长
90 days
期刊介绍: JVIR, published continuously since 1990, is an international, monthly peer-reviewed interventional radiology journal. As the official journal of the Society of Interventional Radiology, JVIR is the peer-reviewed journal of choice for interventional radiologists, radiologists, cardiologists, vascular surgeons, neurosurgeons, and other clinicians who seek current and reliable information on every aspect of vascular and interventional radiology. Each issue of JVIR covers critical and cutting-edge medical minimally invasive, clinical, basic research, radiological, pathological, and socioeconomic issues of importance to the field.
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