Utilization Patterns of Dialysis Interventions: A 5-Year Retrospective Study of Demographic and Procedural Data from Contrasting Institutions.

PURPOSE: To identify patients with increased dialysis access management interventions, assess patterns of use, and examine socioeconomic factors predicting increased procedural recurrence.

MATERIALS AND

METHODS

Retrospective chart reviews of patients who underwent dialysis intervention procedures at a safety-net hospitals (SNHs) and tertiary care centers (TCCs) between 2019 and 2024 were conducted. "Early reintervention patients," defined as patients who underwent 2 or more procedures within a 90-day period, were identified. Demographic and procedural details were collected. Independent t-tests for continuous variables and chi-square tests for categorical variables were used to compare early versus nonearly reintervention patients. Multivariate analysis was performed with multiple logistic regression to identify independent predictors of early reintervention.

RESULTS

The study included 410 patients, with 193 from the TCC and 217 from the SNH. SNH had 107 early reintervention patients (49%), and the TCC had 88 early reintervention patients (46%). The 2 sites had statistically significant differences in sex, race, primary language, and insurance type. Black/African American (32%) and Asian (26.2%) patients were the 2 dominant racial groups of early reintervention patients. Arteriovenous (AV) graft (odds ratio [OR], 3.3; P < .0001), nonroutine examinations (STAT [immediately]/urgent/emergent) (OR, 2.32; P < .00018), and public insurance (OR, 1.74; P < .035) were identified as risk factors for early reintervention status. Age, sex, race, language, site of treatment, and procedure time were not statistically significant predictors of early reintervention status.

CONCLUSIONS

Nonroutine examination order status (STAT/urgent/emergent), public insurance, and the presence of an AV graft were independent predictors of early reintervention.