Department of Surgery, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, Korea.
Department of Surgery, Seoul Medical Center, Seoul, Korea.
J Vasc Access. 2024 Sep;25(5):1544-1552. doi: 10.1177/11297298231180253. Epub 2023 Jun 9.
Arteriovenous (AV) access practice and its outcomes vary internationally. To provide a better understanding of the patterns and outcomes of AV access creation, we investigated the patency and risk factors of arteriovenous fistulas (AVFs) and grafts (AVGs) as initial AV access in the Korean adult population using data from the last 10 years.
The National Health Insurance Service database was queried retrospectively to identify patients undergoing hemodialysis with AVFs and AVGs as well as their clinical characteristics and outcomes from 2008 to 2019. AV access patency and its associated risk factors were evaluated.
During the study period, 64,179 AVFs and 21,857 AVGs were placed. The mean patient age was 62.6 ± 13.6 years (21.5% were ⩾75 years old), and 39.3% patients were women. More than half of the patients underwent AV access creation at tertiary care hospitals. At 1 year, the primary, primary assisted, and secondary patency rates were 62.2%, 80.7%, and 94.2% for AVFs, and 46.0%, 68.4%, and 86.8% for AVGs, respectively. AVG, older age, female sex, diabetes, and creation at general hospitals (vs tertiary hospitals) were associated with decreased patency outcomes (all, < 0.05).
This study using national data showed that three quarters of patients with AV access had AVF and AVF showed superior performance to AVG and identified several patient and center factors related to AV access patency in Korea.
动静脉（AV）通路的实践和结果在国际上有所不同。为了更好地了解 AV 通路建立的模式和结果，我们利用过去 10 年的数据，调查了韩国成年人群中作为初始 AV 通路的动静脉瘘（AVF）和移植物（AVG）的通畅率及其危险因素。
我们通过回顾性查询国家健康保险服务数据库，确定了 2008 年至 2019 年期间接受动静脉瘘和移植物血液透析的患者及其临床特征和结局。评估了 AV 通路的通畅率及其相关危险因素。
在研究期间，共放置了 64179 个 AVF 和 21857 个 AVG。患者的平均年龄为 62.6±13.6 岁（21.5%的患者年龄 ⩾75 岁），39.3%的患者为女性。超过一半的患者在三级护理医院进行 AV 通路建立。在 1 年时，AVF 的主要、主要辅助和次要通畅率分别为 62.2%、80.7%和 94.2%，AVG 分别为 46.0%、68.4%和 86.8%。AVG、年龄较大、女性、糖尿病以及在综合医院（而非三级医院）建立 AV 通路与通畅率降低相关（均 P<0.05）。
这项使用国家数据的研究表明，四分之三的 AV 通路患者有 AVF，AVF 的性能优于 AVG，并确定了与韩国 AV 通路通畅率相关的几个患者和中心因素。
