Key result
MDT care cuts postoperative complications ~68% vs. regular care after AVF surgery.
Why the study?
Various complications may occur during the perioperative period of AVF operation in end-stage renal disease patients, and the effect of multiple disciplinary team medical care on these patients was unclear.
Does multiple disciplinary team (MDT) medical care reduce complications in patients with end-stage renal disease undergoing arteriovenous fistula operation?
RCT (n=96)
Random sampling principle
No
Does multiple disciplinary team (MDT) medical care reduce complications in patients with end-stage renal disease undergoing arteriovenous fistula operation?
Absolute Event Rate: 12% vs 38%
p-value: p=<0.001
Multidisciplinary team medical care significantly reduces perioperative complications and shortens hospitalization time in patients undergoing arteriovenous fistula creation for hemodialysis.
MDT care was associated with fewer AVF complications in ESRD; leaves open need for RCTs before practice change.
Introduction: Arteriovenous fistula (AVF) operation is recognized a gold standard of hemodialysis for end-stage renal disease. Because various complications may occur during perioperative period, medical care plays an important role in improving the possibility of AVF operation. The objective of the study was to explore the effect of the mode of multiple disciplinary team (MDT) medical care on the patients with end-stage renal disease treated by arteriovenous fistula (AVF) operation. Method: 98 patients with end-stage renal disease under the AVF operation were divided into observation group and control group. The control group was performed with regular medical care and for the observation group was treated under the mode of MDT medical care. Complications after operation, hospitalized time and medical satisfaction were comprehensively compared between the both groups. Results: The overall complications including swelling, bleeding, infection and thrombosis in observation group accounted for 5%, however, 19% of patients suffered different complications in the control group. The total complications significantly decreased in the observation group compared with control group (P < 0.001). The hospitalization time was shortened to 9.8 ± 5.6 days in the observation group, and the average hospitalization in control group was 17.8 ± 8.9 days. The medical satisfaction was increased by 20.83 percent in the observation group compared with the control group (P < 0.001). 75% patients in control group were satisfied with medical care, and 98.53% patients were satisfied for observation group. Conclusion: The mode of MDT medical care was beneficial for patients with end-stage renal disease after AVF operation, which could significantly reduce complications, hospitalized time and improve patients’ degree of satisfaction. Thus, it should be recommended in the clinical work.
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Yang et al. (2020) conducted an RCT in End-stage renal disease (n=96). Multiple Disciplinary Team (MDT) medical care vs. Regular medical care was evaluated on Total postoperative complications (swelling, bleeding, infection, thrombosis) (p=<0.001). The multiple disciplinary team medical care mode significantly reduced total postoperative complications to 12% compared to 38% with regular medical care in patients with end-stage renal disease after arteriovenous fistula operation.
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