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KMID : 0371420200980010044
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Annals of Surgical Treatment and Research
2020 Volume.98 No. 1 p.44 ~ p.50
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Development and validation of a clinical score to predict 1-year survival of arteriovenous fistula access: a diagnostic study
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Wongmahisorn Yuthapong
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Abstract
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Purpose: To 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).
Methods: The 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.
Results: Of 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.
Conclusion: The scoring model using clinical data yielded acceptable performance in predicting 1-year access survival among patients receiving a new AVF.
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KEYWORD
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Arteriovenous fistula, End-stage renal disease, Renal dialysis, Treatment outcome
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