A decade of arteriovenous fistula creations in the ⩾75 years population: Equal opportunity or sub-optimal use of resources

• Published in: The journal of vascular access 2024-07, Vol.25 (4), p.1093-1099
• Main Authors: Corr, Michael, Pachchigar, Astha, O’Neill, Michael, Higgins, Rebecca, O’Neill, Stephen, Hanko, Jennifer, Masengu, Agnes
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Aged, 80 and over; Arteriovenous Shunt, Surgical - adverse effects; Databases, Factual; Female; Graft Occlusion, Vascular - etiology; Graft Occlusion, Vascular - physiopathology; Graft Occlusion, Vascular - therapy; Humans; Male; Original s; Quality of Life; Renal Dialysis; Retrospective Studies; Risk Assessment; Risk Factors; Time Factors; Treatment Outcome; Vascular Patency
• ISSN: 1129-7298; 1724-6032; 1724-6032
• DOI: 10.1177/11297298221147571

Background: The optimal vascular access in the elderly remains contentious in the context of increasingly limited resources and anticipated survival on hemodialysis. Research focus has shifted to include the impact of vascular access on quality of life. This study explored clinical outcomes in individuals aged ⩾75 years who had an arteriovenous fistula (AVF) created in a single center over a 10-year period. Materials and methods: Demographic and clinical data concerning AVFs created January 2009–December 2019 were identified from a prospective database for retrospective analysis. Outcome measures were AVF patency and failure to mature rates plus overall patient and vascular access survival. The Vascular Access Specific Quality of life measure (VASQoL) was completed in a contemporary cohort aged ⩾75 years established on HD in October 2021. Results: AVF outcomes were available for 272 patients (93%). The failure to mature (FTM) rate was 36% with the significant predictors of AVF FTM being the creation of a radiocephalic AVF (OR 8.13, 95% CI 8.02–8.52, p