Incidental AVF creation during unrelated hospitalization is associated with worse outcomes compared with outpatient AVF creation

• Published in: The journal of vascular access 2024-03, p.11297298241240169
• Main Authors: Hafeez, Muhammad Saad, Abdul-Malak, Othman M, Reitz, Katherine M, Go, Catherine, Eslami, Mohammad H, Chaer, Rabih A, Yuo, Theodore H
• Format: Article
• Language: English
• ISSN: 1129-7298; 1724-6032; 1724-6032
• DOI: 10.1177/11297298241240169

Arteriovenous fistula (AVF) creation during an inpatient hospitalization is often performed for patient convenience and to ensure compliance. We sought to evaluate whether this approach has comparable outcomes to outpatient AVF creation. We identified patients undergoing index AVF creation from the United States Renal Data System dataset (2012-2017). Patients were grouped into outpatient and inpatient. Outpatient included patients that were operated in either an outpatient setting, ambulatory surgical center or were admitted inpatient on the day of AVF creation. Inpatient included only patients with claims for an inpatient visit before access creation. Multiple safety outcomes were compared between groups using unadjusted and adjusted logistic regression methods generating odds ratios and 95% confidence intervals (95% CI). One-year maturation rates were compared using competing-risks regression methods generating sub-hazard ratios (sHR) and 95% CI. Outcomes were also compared after 1:1 propensity score matching. We identified 68,872 patients undergoing AVF creation, 4855 (7.1%) of which were created during inpatient hospitalization. Patients in the inpatient group were older (65.8 ± 13.8 vs 65.2 ± 13.8,  = 0.002), more likely to be of Black race (28.1% vs 26.8%,  = 0.02), and have cardiovascular comorbidities (all