Model and online calculator for prediction of fistula maturation based on vein dilation and age: A retrospective cohort study in a single-center

Bibliographic Details
Title: Model and online calculator for prediction of fistula maturation based on vein dilation and age: A retrospective cohort study in a single-center
Authors: Jing Sun, Pu-ping Hu, Shen Zhan, Rui Cui, Fang Hou, Yu-zhu Wang
Source: Asian Journal of Surgery, Vol 46, Iss 10, Pp 4267-4276 (2023)
Publisher Information: Elsevier, 2023.
Publication Year: 2023
Collection: LCC:Surgery
Subject Terms: Vein dilation, Radiocephalic arteriovenous fistula, Fistula maturation, Prediction model, Surgery, RD1-811
More Details: Objective: A model that considers the characteristics of dialysis patients may help predict successful fistula maturation. We evaluated factors associated with radiocephalic arteriovenous fistula (RCAVF) maturation at 3 months in dialysis patients with end-stage renal disease (ESRD). Methods: A total of 184 patients who received an initial RCAVF at Beijing Haidian Hospital (Haidian Section of Peking University Third Hospital) were recruited. Fistula maturation was assessed within 3 months. Patient characteristics and preoperative vascular assessment indices were examined. Factors associated with fistula maturation were analyzed using logistic regression and least absolute shrinkage and selection operator (LASSO) binary logistic regression. Boostrapping was used for internal validation. Results: The development data consisted of 184 ESRD patients receiving an initial RCAVF, 140 (76%) of whom achieved fistula maturation. The main predictors of RCAVF maturation in the final model were sex, age-adjusted vein dilation (eVD), radial artery volume (Vartery), and diastolic blood pressure. The difference of vein diameter with and without a tourniquet was significantly larger in the mature RCAVF group (3.0 ± 0.5 vs. 2.2 ± 0.5 mm). The area under receiver operating characteristic (AUROC) curve for prediction of fistula maturation was 0.77, and the Hosmer-Lemeshow statistic indicated agreement between observed and predicted values (P = 0.792). Analysis of internal validation using bootstrapping indicated the C-index was 0.75. Conclusion: The ratio of vein dilation and age were the major predictors of fistula maturation at 3 months in our patients. The resulting online prediction model may help in clinical decision-making for patients receiving a RCAVF.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1015-9584
Relation: http://www.sciencedirect.com/science/article/pii/S1015958423001549; https://doaj.org/toc/1015-9584
DOI: 10.1016/j.asjsur.2023.01.098
Access URL: https://doaj.org/article/0d9bf27a5f3a4fd99cfb05d6ee1eeafb
Accession Number: edsdoj.0d9bf27a5f3a4fd99cfb05d6ee1eeafb
Database: Directory of Open Access Journals
More Details
ISSN:10159584
DOI:10.1016/j.asjsur.2023.01.098
Published in:Asian Journal of Surgery
Language:English