Predicting Outcomes in Native AV Forearm Radio-cephalic Fistulae; the CAVeA<sub>2</sub>T<sub>2</sub>Scoring System

Bosanquet, David C.; Rubasingham, J.; Imam, Mariam; Woolgar, Justin; Davies, C.

doi:10.5301/jva.5000305

Cited by 14 publications

(15 citation statements)

References 34 publications

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“…However, the survival time evaluated by these models was not longer than two years. [16][17][18] Given that the median survival of AVFs was approximately 3.2 years, 7) a prediction model that can forecast AVF survival for a longer duration would be beneficial.…”

Section: Introductionmentioning

confidence: 99%

Survival and Prognostic Predictors of Primary Arteriovenous Fistula for Hemodialysis

Wongmahisorn

2019

Annals of Vascular Diseases

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Objectives: This study aims to evaluate the survival and prognostic predictors of arteriovenous fistulas (AVFs) among patients undergoing AVF creation. The significant predictors were incorporated into a prognostic model to determine its prognostic performance for five-year AVF survival. Materials and Methods: Data on 290 patients who underwent first-time AVF creation and who had been followed up for at least 5 years or until AVF failure were reviewed. The Kaplan-Meier survival curves and Cox proportional hazards model were generated to determine the AVF survival and associated prognostic predictors. Significant predictors were used to derive a prognostic model. Results: The mean age of the patients was 59.7±14.6 years, and the 5-year AVF survival rate was 34.5%. Three features were found to be independent prognostic factors for the five-year AVF survival: old age, diabetes mellitus, and prior central venous catheter placement. These three significant factors were integrated into a prognostic scoring model that ranged from zero to five points. According to this model, the patients whose scores were 0, 1, 2, 3 and 4 or more had five-year AVF survival rates of 60.0%, 45.3%, 36.6%, 15.0%, and 2.9%, respectively. Conclusion: The five-year survival rate of AVFs was modest, and a prognostic model could excellently estimate the fiveyear AVF survival.

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Section: Introductionmentioning

confidence: 99%

Survival and Prognostic Predictors of Primary Arteriovenous Fistula for Hemodialysis

Wongmahisorn

2019

Annals of Vascular Diseases

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“…(10,11,12,13) This is a typical problem in studies of vascular access as 9 different and often non-standardized outcomes are commonly described in different studies making comparison challenging and recommendations for standard outcome measures is mandated. (17) The number of patients involved in the modelling process in the identified studies (n=218 to 422) compares poorly to available models on other topics such as end stage renal failure where numerous models used over 5000 patients.…”

Section: Discussionmentioning

confidence: 99%

“…Three models used multivariable regression model whilst the other two models used a series of separate univariable cox regression analyses. All studies clearly identified the type of statistical method that they used to derive the prediction model, two were derived using a Cox proportional hazards model (12,13) and three models used logistic regression (10,11).…”

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confidence: 99%

“…Three models (10,11) (60%) conducted an internal validation of the prediction model with bootstrapping, with one of them also using an internal cross validation and external validation (11), In our opinion two studies did not sufficiently assess their models to validate them. (12,13) Three studies (11,12,13) (60%) derived simplified scoring systems from the risk prediction models. One study (11) derived a simple points system by rounding odds ratios to the nearest integer, whereby the resulting score would be a simple summation of the integers.…”

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Predictive Models for Arteriovenous Fistula Maturation

et al. 2016

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Haemodialysis (HD) is a lifeline therapy for patients with end stage renal disease (ESRD). A critical factor in the survival of renal dialysis patients is the surgical creation of vascular access and international guidelines recommend arteriovenous fistulas (AVF) as the gold standard of vascular access for haemodialysis. Despite this, AVFs have been associated with high failure rates. Although risk factors for AVF failure have been identified, their utility for predicting AVF failure through predictive models remains unclear. The objectives of this review are to systematically and critically assess the methodology and reporting of studies developing prognostic predictive models for AVF outcomes and assess them for suitability in clinical practice.Electronic databases were searched for studies reporting prognostic predictive models for AVF outcomes. Dual review was conducted to identify studies that reported on the development or validation of a model constructed to predict AVF outcome following creation. Data was extracted on study characteristics, risk predictors, statistical methodology, type of model as well as validation process. We included 4 different studies reporting five different predictive models. Parameters identified that were common to all scoring system were age and cardiovascular disease.This review has found a small number of predictive models in vascular access. The disparity between each study limits the development of a unified predictive model.

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“…To date, few studies have incorporated the clinical features of patients into a prediction model for AVF nonmaturation or AVF failure after creation [1415161718]. Additionally, no study has developed a scoring system to predict the survival of AVF after maturation.…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a clinical score to predict 1-year survival of arteriovenous fistula access: a diagnostic study

Wongmahisorn

2020

Ann Surg Treat Res

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PurposeTo develop and validate a clinical scoring model to predict 1-year access survival among end-stage renal disease (ESRD) patients who received a new arteriovenous fistula (AVF).MethodsThe data of 195 ESRD patients in the development cohort who underwent first-time AVF creation between January 2009 and June 2013 and who had successful cannulation for dialysis use were reviewed. The clinical features that were significantly associated with 1-year AVF survival were incorporated into a clinical scoring model. The validity of this clinical score was then tested in a validation cohort of 204 ESRD patients who received a new AVF between July 2013 and December 2017.ResultsOf the 195 patients in the development cohort, 168 patients (86.2%) had a well-functioning AVF at 1 year. Absence of diabetes mellitus, no previous history of central venous catheter insertion, and absence of intervention performed to achieve access maturation were positively associated with 1-year AVF survival. These 3 factors were incorporated into a clinical scoring model, which ranged from 0 to 4 points. For a cutoff score of ≥3, the sensitivity, specificity and area under the receiver operating characteristic curve to predict 1-year AVF survival were 81.5%, 70.4%, and 0.760, respectively. The predictive performance of the clinical score was confirmed in the validation cohort, with a sensitivity of 76.1%, a specificity of 64.4% and an area under the curve of 0.703.ConclusionThe scoring model using clinical data yielded acceptable performance in predicting 1-year access survival among patients receiving a new AVF.

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Predicting Outcomes in Native AV Forearm Radio-cephalic Fistulae; the CAVeA₂T₂Scoring System

Cited by 14 publications

References 34 publications

Survival and Prognostic Predictors of Primary Arteriovenous Fistula for Hemodialysis

Survival and Prognostic Predictors of Primary Arteriovenous Fistula for Hemodialysis

Predictive Models for Arteriovenous Fistula Maturation

Development and validation of a clinical score to predict 1-year survival of arteriovenous fistula access: a diagnostic study

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Predicting Outcomes in Native AV Forearm Radio-cephalic Fistulae; the CAVeA2T2Scoring System

Cited by 14 publications

References 34 publications

Survival and Prognostic Predictors of Primary Arteriovenous Fistula for Hemodialysis

Survival and Prognostic Predictors of Primary Arteriovenous Fistula for Hemodialysis

Predictive Models for Arteriovenous Fistula Maturation

Development and validation of a clinical score to predict 1-year survival of arteriovenous fistula access: a diagnostic study

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Predicting Outcomes in Native AV Forearm Radio-cephalic Fistulae; the CAVeA₂T₂Scoring System