Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing City, China.
J Vasc Access. 2024 Sep;25(5):1467-1473. doi: 10.1177/11297298231163224. Epub 2023 Mar 27.
Health-related quality of life (HRQoL) has been demonstrated to predict mortality in patients receiving maintenance hemodialysis (MHD). Vascular access (VA) is critical for MHD patients. The aim of this study was to investigate the change in HRQoL among MHD patients with a 2-year follow-up and to explore the impact of VA satisfaction on HRQoL in this population.
229 MHD patients in two dialysis centers were included in this observational prospective study. VA satisfaction was assessed using the Vascular Access Questionnaire (VAQ). The 36 Item Short-Form Health Survey (SF-36) questionnaire was employed to evaluate HRQoL scores. Multiple logistic regression analysis was used to evaluate the influencing factors of HRQoL.
A total of 229 MHD patients were enrolled in the study, and 198 individuals (86.46%) completed the 2-year follow-up. HRQoL decreased statistically significantly from baseline to the 2-year follow-up across all dimensions. Multivariable analyses showed that the overall score, social functioning score, dialysis-related complication score of VAQ influenced HRQoL in the study population. Furthermore, HRQoL total scores and scores on the physical component summary (PCS) and mental component summary (MCS) domains were significantly higher in the satisfied VA group than in the dissatisfied group at baseline. After the 2-year follow-up, patients with a higher level of VA satisfaction reported higher HRQoL than patients with lower VA satisfaction.
Our data suggested that VA satisfaction was significantly associated with HRQoL in MHD patients. These findings imply that surgeons and nephrologists should incorporate patient satisfaction into VA surgical decision-making.
健康相关生活质量(HRQoL)已被证明可预测接受维持性血液透析(MHD)的患者的死亡率。血管通路(VA)对 MHD 患者至关重要。本研究旨在调查 2 年随访期间 MHD 患者 HRQoL 的变化,并探讨该人群中 VA 满意度对 HRQoL 的影响。
本观察性前瞻性研究纳入了两个透析中心的 229 名 MHD 患者。使用血管通路问卷(VAQ)评估 VA 满意度。采用 36 项简明健康调查问卷(SF-36)评估 HRQoL 评分。采用多因素逻辑回归分析评估 HRQoL 的影响因素。
共纳入 229 名 MHD 患者,198 名患者(86.46%)完成了 2 年随访。所有维度的 HRQoL 均从基线显著下降到 2 年随访。多变量分析显示,VAQ 的总体评分、社会功能评分和与透析相关的并发症评分影响了研究人群的 HRQoL。此外,VA 满意度高的患者 HRQoL 总分以及生理成分综合评分(PCS)和心理成分综合评分(MCS)得分均高于基线时 VA 满意度低的患者。在 2 年随访后,VA 满意度较高的患者报告的 HRQoL 高于 VA 满意度较低的患者。
我们的数据表明,VA 满意度与 MHD 患者的 HRQoL 显著相关。这些发现表明,外科医生和肾病医生应将患者满意度纳入 VA 手术决策中。