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Validation of the failure to maturation equation and proposal for a novel scoring system for arteriovenous fistula maturation in multiethnic Asian haemodialysis patients.
J Vasc Access 2019; :1129729819865463JV

Abstract

INTRODUCTION

A successful arteriovenous fistula is essential for effective haemodialysis. We aim to validate the existing failure to maturation equation and to propose a new clinical scoring system by evaluating arteriovenous fistula success predictors.

METHODS

Data of end-stage renal disease patients initiated on haemodialysis from January 2010 to December 2012 were retrospectively obtained from medical records with follow-up until 1 January 2014. Application of the failure to maturation equation was evaluated. A nomogram was developed using arteriovenous fistula success predictors and was calibrated with a bootstrapping technique.

RESULTS

A total of 694 patients were included with mean duration of follow-up of 2.3 years. Arteriovenous fistula maturation was achieved by 542 patients (78%). Comparing our cohort with the failure to maturation cohort, there were statistically significant differences in mean age, ethnicity and presence of diabetes mellitus. The failure to maturation equation failed to predict arteriovenous fistula outcomes with area under the curve performance of 0.519 on a receiver operating characteristic curve. Multivariate logistic regression showed that Malay patients (odds ratio = 0.628; 95% confidence interval = 0.403-0.978; p < 0.05) and patients requiring preoperative vein mapping (odds ratio = 0.601; 95% confidence interval = 0.410-0.883; p < 0.01) had a lower chance of arteriovenous fistula success, whereas male gender (odds ratio = 1.526; 95% confidence interval = 1.040-2.241; p < 0.05) and presence of postoperative good thrill (odds ratio = 3.137; 95% confidence interval = 2.127-4.625; p < 0.0001) had a higher chance of arteriovenous fistula success. The derived nomogram predicted arteriovenous fistula success (odds ratio = 1.030; 95% confidence interval = 1.022-1.038; p < 0.0001) with the area under the curve of 0.695 on a receiver operating characteristic curve and an adequacy index of 99.86% (p < 0.0001).

CONCLUSION

The failure to maturation equation was not validated in our cohort. The clinical utility of our proposed arteriovenous fistula scoring system requires external validation in larger studies.

Authors+Show Affiliations

1 Department of Renal Medicine, Singapore General Hospital, Singapore.1 Department of Renal Medicine, Singapore General Hospital, Singapore.1 Department of Renal Medicine, Singapore General Hospital, Singapore.1 Department of Renal Medicine, Singapore General Hospital, Singapore.1 Department of Renal Medicine, Singapore General Hospital, Singapore.1 Department of Renal Medicine, Singapore General Hospital, Singapore.2 Health Services Research Unit, Singapore General Hospital, Singapore.3 Yong Loo Lin School of Medicine, National University of Singapore, Singapore.3 Yong Loo Lin School of Medicine, National University of Singapore, Singapore.3 Yong Loo Lin School of Medicine, National University of Singapore, Singapore.4 Department of Vascular Surgery, Singapore General Hospital, Singapore.1 Department of Renal Medicine, Singapore General Hospital, Singapore.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31364454

Citation

Tng, Alvin Ren Kwang, et al. "Validation of the Failure to Maturation Equation and Proposal for a Novel Scoring System for Arteriovenous Fistula Maturation in Multiethnic Asian Haemodialysis Patients." The Journal of Vascular Access, 2019, p. 1129729819865463.
Tng ARK, Lee KG, Tan RY, et al. Validation of the failure to maturation equation and proposal for a novel scoring system for arteriovenous fistula maturation in multiethnic Asian haemodialysis patients. J Vasc Access. 2019.
Tng, A. R. K., Lee, K. G., Tan, R. Y., Pang, S. C., Foo, M. W. Y., Choong, H. L., ... Tan, C. S. (2019). Validation of the failure to maturation equation and proposal for a novel scoring system for arteriovenous fistula maturation in multiethnic Asian haemodialysis patients. The Journal of Vascular Access, p. 1129729819865463. doi:10.1177/1129729819865463.
Tng ARK, et al. Validation of the Failure to Maturation Equation and Proposal for a Novel Scoring System for Arteriovenous Fistula Maturation in Multiethnic Asian Haemodialysis Patients. J Vasc Access. 2019 Jul 31;1129729819865463. PubMed PMID: 31364454.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Validation of the failure to maturation equation and proposal for a novel scoring system for arteriovenous fistula maturation in multiethnic Asian haemodialysis patients. AU - Tng,Alvin Ren Kwang, AU - Lee,Kian Guan, AU - Tan,Ru Yu, AU - Pang,Suh Chien, AU - Foo,Marjorie Wai Yin, AU - Choong,Hui Lin, AU - Li,Hui Hua, AU - Goh,Nicholette, AU - Shaam,Achudan, AU - Tan,Yi Liang, AU - Chong,Tze Tec, AU - Tan,Chieh Suai, Y1 - 2019/07/31/ PY - 2019/8/1/entrez KW - Arteriovenous fistula KW - arteriovenous fistula success prediction KW - haemodialysis KW - predictor score SP - 1129729819865463 EP - 1129729819865463 JF - The journal of vascular access JO - J Vasc Access N2 - INTRODUCTION: A successful arteriovenous fistula is essential for effective haemodialysis. We aim to validate the existing failure to maturation equation and to propose a new clinical scoring system by evaluating arteriovenous fistula success predictors. METHODS: Data of end-stage renal disease patients initiated on haemodialysis from January 2010 to December 2012 were retrospectively obtained from medical records with follow-up until 1 January 2014. Application of the failure to maturation equation was evaluated. A nomogram was developed using arteriovenous fistula success predictors and was calibrated with a bootstrapping technique. RESULTS: A total of 694 patients were included with mean duration of follow-up of 2.3 years. Arteriovenous fistula maturation was achieved by 542 patients (78%). Comparing our cohort with the failure to maturation cohort, there were statistically significant differences in mean age, ethnicity and presence of diabetes mellitus. The failure to maturation equation failed to predict arteriovenous fistula outcomes with area under the curve performance of 0.519 on a receiver operating characteristic curve. Multivariate logistic regression showed that Malay patients (odds ratio = 0.628; 95% confidence interval = 0.403-0.978; p < 0.05) and patients requiring preoperative vein mapping (odds ratio = 0.601; 95% confidence interval = 0.410-0.883; p < 0.01) had a lower chance of arteriovenous fistula success, whereas male gender (odds ratio = 1.526; 95% confidence interval = 1.040-2.241; p < 0.05) and presence of postoperative good thrill (odds ratio = 3.137; 95% confidence interval = 2.127-4.625; p < 0.0001) had a higher chance of arteriovenous fistula success. The derived nomogram predicted arteriovenous fistula success (odds ratio = 1.030; 95% confidence interval = 1.022-1.038; p < 0.0001) with the area under the curve of 0.695 on a receiver operating characteristic curve and an adequacy index of 99.86% (p < 0.0001). CONCLUSION: The failure to maturation equation was not validated in our cohort. The clinical utility of our proposed arteriovenous fistula scoring system requires external validation in larger studies. SN - 1724-6032 UR - https://www.unboundmedicine.com/medline/citation/31364454/Validation_of_the_failure_to_maturation_equation_and_proposal_for_a_novel_scoring_system_for_arteriovenous_fistula_maturation_in_multiethnic_Asian_haemodialysis_patients L2 - http://journals.sagepub.com/doi/full/10.1177/1129729819865463?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -