@article{Suwitchakul_2010, title={Outcome of Autogenous Arteriovenous Fistula for Hemodialysis in Elderly Patients with End Stage Renal Disease}, volume={31}, url={https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/227610}, abstractNote={<div><strong>Objective:</strong> To study functional outcomes, in terms of 1-, 3-, 5-year patency rate and post-operative<br>complications in patients with end-stage renal disease (ESRD) who underwent autogenous arteriovenous fistulas<br>for hemodialysis and to compare the outcomes in patients aged over 60 years and those of patients age under<br>60 years.</div> <div><br><strong>Materials and Methods:</strong> All records of the patients who underwent autogenous arteriovenous fistula<br>between January 2003 and June 2007 were reviewed. The patency rates and complications were analyzed in both<br>groups. The statistic analysis included chi-square test, independent samples t-test, Fisher’s exact test, Kaplan-<br>Meier survival analysis with log rank test comparison and Cox regression analysis.</div> <div><br><strong>Results:</strong> From 343 patients, 217 patients met the inclusion criteria. All were divided into two groups<br>according to the age group. Group 1 (age over 60 years) consisted of 112 patients and Group 2 (age under 60<br>years) consisted of 105 patients. There were no differences in terms of gender, co-morbid diseases, type of<br>arteriovenous fistula and biochemical data before operation but only differences in duration of ESRD before operation<br>(p = 0.028). The patency rates at 1, 3 and 5 years were 76.8%, 54.5% and 48.2% for patients aged over 60 and 81%,<br>65.2% and 53.3% for patients aged under 60, respectively. There were no significant differences in patency rate for<br>AVF between both groups (p-value = 0.387). In age over 60 years group, gender and type of fistula were not significant<br>differences in patency but diabetes was significant differences in patency (p = 0.001). There were no significant<br>differences in complication between both groups. Multivariate analysis demonstrated significant correlation between<br>the patency loss and these variables: diabetes (HR = 2.837; 95%CI = 1.912-4.208, p <0.001), active bleeding or<br>hematoma at surgical site (HR = 4.281; 95%CI = 1.328-13.795, p = 0.015) and surgical site infection (HR = 8.642; 95%<br>CI = 3.079-24.255, p <0.001).</div> <div><br><strong>Conclusion:</strong> Autogenous arteriovenous fistula is the first angioaccess for hemodialysis also in older<br>patients. Survival of the autogenous arteriovenous fistula is independent of age. There is no difference in<br>autogenous arteriovenous fistula complications across age groups. Diabetes were related to patency loss in older<br>patients.</div>}, number={4}, journal={The Thai Journal of Surgery}, author={Suwitchakul, Chaiyaporn}, year={2010}, month={Dec.} }