Comparison of outcomes of arteriovenous grafts and fistulas at a single Veterans' Affairs medical center.
BACKGROUND
Before 2003, almost all dialysis access procedures performed at the G.V. Montgomery Veterans' Affairs Medical Center were arteriovenous grafts. In mid-2003, it was decided to place fistulas in most patients. This study compared the patency rates and frequency of interventions to maintain function between the 2 procedures.


METHODS
Patency rates for 64 grafts and 50 fistulas were computed using Kaplan-Meier life-tables and compared using the Cox-Mantel log- rank test. The frequency of interventions to maintain function was compared using a Poisson model.


RESULTS
Primary patency of grafts at 1 and 2 years was 39% and 26%, and that of fistulas was 44% and 37%. Secondary patency of grafts at 1 and 2 years was 71% and 63%, and that of fistulas was 75% and 72%. Neither difference reached significance. The difference in interventions also was insignificant.


CONCLUSIONS
Switching from grafts to fistulas did not significantly improve the patency and frequency of interventions.
Snyder
David C
DC
Department of General Surgery, G.V. (Sonny) Montgomery VA Medical Center, 1500 Woodrow Wilson Dr., Jackson, MS 39216, USA. david.snyder4@va.gov
Clericuzio
Charles P
CP
Stringer
Anthony
A
May
Warren
W
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D016016:Proportional Hazards Models; D006435:Renal Dialysis; D014654:Vascular Patency