Roşu Cristian Dan, Bolintineanu Sorin Lucian, Căpăstraru Bogdan Florin, Iacob Roxana, Stoicescu Emil Robert, Petrea Claudia Elena
1st Surgery Clinic, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania.
Department of Anatomy and Embriology, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.
Diagnostics (Basel). 2025 Jan 2;15(1):88. doi: 10.3390/diagnostics15010088.
Chronic kidney disease (CKD) and renal failure remain critical global health challenges, with vascular access complications posing significant obstacles in hemodialysis management. This study investigates the early and late complications associated with vascular access procedures in a cohort of 1334 patients from Timiș County Emergency Clinical Hospital. Patients were categorized into early complications, occurring within 30 days postoperatively, and late complications, developing beyond this period. Demographic data, comorbidities, and lifestyle factors, including age, gender, body mass index (BMI), smoking status, hypertension, diabetes, and cardiovascular disease (CVD), were recorded and analyzed. Early complications included thrombosis, hemorrhage, edema, and non-maturation, while late complications involved thrombosis, aneurysmal dilation, venous hypertension, and infections. : Hemorrhage (32.3%) and thrombosis (30.8%) were the most prevalent early complications, influenced significantly by diabetes and hypertension. Non-maturation showed a strong association with diabetes and cardiovascular disease (odds ratio: 1.70). For late complications, thrombosis was most frequent, with hypertensive patients exhibiting increased risk (relative risk: 1.18). BMI was a significant factor in both early and late complications. Risk analysis using odds ratios and relative risks revealed distinct patterns of complication risks based on comorbidities and smoking status. Logistic regression modeling for thrombosis demonstrated moderate predictive accuracy (AUC: 0.64). : These findings suggest that clinical interventions, such as stricter perioperative glycemic and blood pressure control, and personalized surgical strategies for patients with high BMI or comorbidities, could significantly reduce the incidence of vascular access complications and improve outcomes in this high-risk population.
慢性肾脏病（CKD）和肾衰竭仍然是全球严峻的健康挑战，血管通路并发症在血液透析管理中构成了重大障碍。本研究调查了蒂米什县急诊临床医院1334例患者队列中与血管通路手术相关的早期和晚期并发症。患者被分为术后30天内发生的早期并发症和在此之后发生的晚期并发症。记录并分析了人口统计学数据、合并症和生活方式因素，包括年龄、性别、体重指数（BMI）、吸烟状况、高血压、糖尿病和心血管疾病（CVD）。早期并发症包括血栓形成、出血、水肿和未成熟，而晚期并发症包括血栓形成、动脉瘤样扩张、静脉高压和感染。出血（32.3%）和血栓形成（30.8%）是最常见的早期并发症，受糖尿病和高血压的影响显著。未成熟与糖尿病和心血管疾病有很强的关联（优势比：1.70）。对于晚期并发症，血栓形成最为常见，高血压患者的风险增加（相对风险：1.18）。BMI在早期和晚期并发症中都是一个重要因素。使用优势比和相对风险进行的风险分析揭示了基于合并症和吸烟状况的不同并发症风险模式。血栓形成的逻辑回归模型显示出中等预测准确性（AUC：0.64）。这些发现表明，临床干预措施，如更严格的围手术期血糖和血压控制，以及针对高BMI或合并症患者的个性化手术策略，可显著降低血管通路并发症的发生率，并改善这一高危人群的治疗结果。
