Clinical utility of a traditional score system for the evaluation of the peritoneal dialysis exit-site infection in a national multicentric cohort study
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1177/0896860820949032 http://hdl.handle.net/11449/202052 |
Resumo: | Introduction: Exit-site infection (ESI) is an important risk factor for peritonitis in patients under chronic peritoneal dialysis (PD). The International Society for Peritoneal Dialysis (ISPD) recommend its diagnosis as the presence of purulent drainage in the exit site (ES) but time-consuming scores using others skin signs are routinely used. Objective: To investigate the correlation between the diagnosis of ESI with a score based on five clinical signs obtained from ES inspection, and also if there are interaction with patient’s race. Methods: Multicenter and prospective cohort. We included adult patients from 122 clinics, incident on PD and with a 12-month stay in therapy. The event of interest was ESI, defined as purulent drainage. The clinical score used was composed of hyperemia, edema, pain, scab, and granuloma. Statistical analysis was performed using multilevel logistic regression model, likelihood test, and Cohen concordance analysis. Results: A total of 35,354 ES assessments were performed during the first year of dialysis in 3297 patients. There was a rate of 10.1 (9.1–11.2) episodes of ESI per 1000 patients/month. In patients with ESI, the prevalence of hyperemia was 55.9%, edema 67.3%, pain 31.8%, and scab 23.2%. The agreement with the score was 60.6% and showed differences according to the patient’s race, being 53.2% for African Americans descendants and 65.4% for others. The use of scales for the diagnosis of ESI does not add much information in addition to the presence of purulent secretion as currently recommended by the ISPD. |
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Repositório Institucional da UNESP |
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Clinical utility of a traditional score system for the evaluation of the peritoneal dialysis exit-site infection in a national multicentric cohort studyCatheterexit-site infectioninfectionnephrologyperitoneal dialysisIntroduction: Exit-site infection (ESI) is an important risk factor for peritonitis in patients under chronic peritoneal dialysis (PD). The International Society for Peritoneal Dialysis (ISPD) recommend its diagnosis as the presence of purulent drainage in the exit site (ES) but time-consuming scores using others skin signs are routinely used. Objective: To investigate the correlation between the diagnosis of ESI with a score based on five clinical signs obtained from ES inspection, and also if there are interaction with patient’s race. Methods: Multicenter and prospective cohort. We included adult patients from 122 clinics, incident on PD and with a 12-month stay in therapy. The event of interest was ESI, defined as purulent drainage. The clinical score used was composed of hyperemia, edema, pain, scab, and granuloma. Statistical analysis was performed using multilevel logistic regression model, likelihood test, and Cohen concordance analysis. Results: A total of 35,354 ES assessments were performed during the first year of dialysis in 3297 patients. There was a rate of 10.1 (9.1–11.2) episodes of ESI per 1000 patients/month. In patients with ESI, the prevalence of hyperemia was 55.9%, edema 67.3%, pain 31.8%, and scab 23.2%. The agreement with the score was 60.6% and showed differences according to the patient’s race, being 53.2% for African Americans descendants and 65.4% for others. The use of scales for the diagnosis of ESI does not add much information in addition to the presence of purulent secretion as currently recommended by the ISPD.School of Medicine Pontifical Catholic University of Paraná(PUCPRSchool of Primary Keele UniversityUniversidade Estadual Paulista (UNESPUniversidade Estadual Paulista (UNESPPontifical Catholic University of Paraná(PUCPRKeele UniversityUniversidade Estadual Paulista (Unesp)Rigo, MarianePecoits-Filho, RobertoLambie, MarkTuon, Felipe FranciscoBarretti, Pasqual [UNESP]de Moraes, Thyago Proença2020-12-12T02:48:35Z2020-12-12T02:48:35Z2020-01-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://dx.doi.org/10.1177/0896860820949032Peritoneal Dialysis International.1718-43040896-8608http://hdl.handle.net/11449/20205210.1177/08968608209490322-s2.0-8508997833754964119838934790000-0003-4979-4836Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengPeritoneal Dialysis Internationalinfo:eu-repo/semantics/openAccess2024-08-14T17:22:13Zoai:repositorio.unesp.br:11449/202052Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-14T17:22:13Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Clinical utility of a traditional score system for the evaluation of the peritoneal dialysis exit-site infection in a national multicentric cohort study |
title |
Clinical utility of a traditional score system for the evaluation of the peritoneal dialysis exit-site infection in a national multicentric cohort study |
spellingShingle |
Clinical utility of a traditional score system for the evaluation of the peritoneal dialysis exit-site infection in a national multicentric cohort study Rigo, Mariane Catheter exit-site infection infection nephrology peritoneal dialysis |
title_short |
Clinical utility of a traditional score system for the evaluation of the peritoneal dialysis exit-site infection in a national multicentric cohort study |
title_full |
Clinical utility of a traditional score system for the evaluation of the peritoneal dialysis exit-site infection in a national multicentric cohort study |
title_fullStr |
Clinical utility of a traditional score system for the evaluation of the peritoneal dialysis exit-site infection in a national multicentric cohort study |
title_full_unstemmed |
Clinical utility of a traditional score system for the evaluation of the peritoneal dialysis exit-site infection in a national multicentric cohort study |
title_sort |
Clinical utility of a traditional score system for the evaluation of the peritoneal dialysis exit-site infection in a national multicentric cohort study |
author |
Rigo, Mariane |
author_facet |
Rigo, Mariane Pecoits-Filho, Roberto Lambie, Mark Tuon, Felipe Francisco Barretti, Pasqual [UNESP] de Moraes, Thyago Proença |
author_role |
author |
author2 |
Pecoits-Filho, Roberto Lambie, Mark Tuon, Felipe Francisco Barretti, Pasqual [UNESP] de Moraes, Thyago Proença |
author2_role |
author author author author author |
dc.contributor.none.fl_str_mv |
Pontifical Catholic University of Paraná(PUCPR Keele University Universidade Estadual Paulista (Unesp) |
dc.contributor.author.fl_str_mv |
Rigo, Mariane Pecoits-Filho, Roberto Lambie, Mark Tuon, Felipe Francisco Barretti, Pasqual [UNESP] de Moraes, Thyago Proença |
dc.subject.por.fl_str_mv |
Catheter exit-site infection infection nephrology peritoneal dialysis |
topic |
Catheter exit-site infection infection nephrology peritoneal dialysis |
description |
Introduction: Exit-site infection (ESI) is an important risk factor for peritonitis in patients under chronic peritoneal dialysis (PD). The International Society for Peritoneal Dialysis (ISPD) recommend its diagnosis as the presence of purulent drainage in the exit site (ES) but time-consuming scores using others skin signs are routinely used. Objective: To investigate the correlation between the diagnosis of ESI with a score based on five clinical signs obtained from ES inspection, and also if there are interaction with patient’s race. Methods: Multicenter and prospective cohort. We included adult patients from 122 clinics, incident on PD and with a 12-month stay in therapy. The event of interest was ESI, defined as purulent drainage. The clinical score used was composed of hyperemia, edema, pain, scab, and granuloma. Statistical analysis was performed using multilevel logistic regression model, likelihood test, and Cohen concordance analysis. Results: A total of 35,354 ES assessments were performed during the first year of dialysis in 3297 patients. There was a rate of 10.1 (9.1–11.2) episodes of ESI per 1000 patients/month. In patients with ESI, the prevalence of hyperemia was 55.9%, edema 67.3%, pain 31.8%, and scab 23.2%. The agreement with the score was 60.6% and showed differences according to the patient’s race, being 53.2% for African Americans descendants and 65.4% for others. The use of scales for the diagnosis of ESI does not add much information in addition to the presence of purulent secretion as currently recommended by the ISPD. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-12-12T02:48:35Z 2020-12-12T02:48:35Z 2020-01-01 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1177/0896860820949032 Peritoneal Dialysis International. 1718-4304 0896-8608 http://hdl.handle.net/11449/202052 10.1177/0896860820949032 2-s2.0-85089978337 5496411983893479 0000-0003-4979-4836 |
url |
http://dx.doi.org/10.1177/0896860820949032 http://hdl.handle.net/11449/202052 |
identifier_str_mv |
Peritoneal Dialysis International. 1718-4304 0896-8608 10.1177/0896860820949032 2-s2.0-85089978337 5496411983893479 0000-0003-4979-4836 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Peritoneal Dialysis International |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
|
_version_ |
1808128109337116672 |