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Results for “Life Table Method”

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At least 343 records · Page 19Linked to original sources

PubMed2005

Mortality after low-energy fractures in patients aged at least 45 years old.

BACKGROUND: Fractures sustained in low-energy injuries are recognized as a major public health issue, although, with the exception of proximal femoral fractures, little is known about the subsequent mortality rates. The aim of this study was to compare the survival rates of a population of individuals who sustained 3 types of low-energy fractures with age-matched cohorts from within the same population. METHODS: Between January 1988 and December 1999, data were prospectively gathered from all inpatient and outpatient fracture cases at a single trauma unit. During this time, 18,019 patients sustained low-energy fractures of the proximal femur, proximal humerus, or wrist. Survival analysis using the life table method was performed and hazard ratios calculated for risk of mortality when compared to general population controls within the first year postinjury, between the second and fifth years postinjury, and between the sixth and tenth years postinjury. The effects of various social, physical, and mental health parameters on survival were also analyzed using a Cox proportional hazards model. RESULTS: The patients who sustained proximal femoral fractures were older and significantly more physically and mentally impaired than the patients who sustained wrist fractures. The demographic features of the proximal humeral fracture cohort were intermediate between these 2 groups. The mortality was high in all age groups following proximal femoral and proximal humeral fractures, though the relative risk of death, when compared to age-matched population controls, decreased with increasing age at fracture. The risk of death in these groups was greatest in younger individuals and in the first year postinjury. The wrist fracture population had similar or enhanced survival when compared to age-matched population controls. The mortality after fracture was independently predicted by age at fracture, male gender, and use of walking aids, for all 3 fracture groups (P < 0.05), and additionally by level of social dependence in the proximal femoral fracture group (P < 0.05). LEVEL OF EVIDENCE: level one, prospective cohort study. CONCLUSIONS: There is prolonged risk of premature mortality seen in both proximal femoral and proximal humeral fracture groups in the younger age cohorts, possibly as a result of concomitant medical comorbidities contributing to their premature deaths. Elderly patients sustaining proximal femoral fractures, despite high risk of mortality in the first year after injury, have survival approaching those of the general population in the longer term. Elderly patients who sustain wrist fractures have consistently better survival rates than the general population. This group of patients may be physiologically more robust than their age-matched peers in the general population.

Accidental Falls↗

PubMed1978

Follow-up study of sealing and filling with composite resins in the prevention of occlusal caries.

A diluted composite resin (Concise diluted with Concise Enamel Bond) was used for fissure sealing and filling in 896 permanent first molars of 281 children, initially 5--7 years of age. Ordinary fissure sealing was used for fissures with no apparent caries, while a filling method was used after an explorative drilling with a small round bur (Ash No. 1/2) in fissures with incipient caries. On the basis of clinical evaluation every 6 months, the frequency of total retention of the composite material after different observation periods was calculated using the life table method. The rate of success in the fissure sealing group was 94.8% after 6 months, falling to 75.2% after 30 months. The corresponding data for the filled teeth were 92.6 % and 83.5%. It would seem that diluted composite resin is well suited for the prevention of caries in pits and fissures.

Child↗

PubMed2004

Survival of patients with stomach cancer in Changle city of China.

AIM: The survival rate of patients with stomach cancer is used to evaluate the effects of treatments. The short- and mid-term survival of patients on the present level of treatments can be described by calculating 1- to 5-year survival rates. The aims of this study were to document patterns of survival after treatments for stomach cancer in Changle city and analyze whether the stage of cancer and the way of treatment impacted on survival of patients or not. METHODS: A total number of 745 patients with stomach cancer reported in the Changle Cancer Registry from 1993 to 1998 were investigated with respect to the disease condition, the way of treatment and survival time. 1- to 5-year survival rates were estimated by using life-table method. RESULTS: The 1- to 5-year survival rates in the patients with stomach cancer in Changle city were 54.23%, 41.77%, 37.95%, 33.98% and 30.47%, respectively. The 1- to 5-year survival rates in stage I or II group were 3, 6.1, 7.4, 8.9 and 9.8 times as high as those in stage III or IV group, respectively. The 1- to 5-year survival rates in operation group were 3.5, 8.7, 11.2, 11.7 and 19 times as high as those in no operation group, respectively. For the patients with stage III or IV stomach cancer the 1-year survival rate in operation group was 3 times as high as that in no operation group and 2-year survival rate in operation group was 11.9 times as high as that in no operation group. For the patients with stage III or IV stomach cancer, the differences of the survival rates average survival times between total gastrectomy and partial gastrectomy were not significant and the median survival times in these 2 groups were 8 mo and 9 mo, respectively. CONCLUSION: Mid-term survival rates of patients with stomach cancer in Changle city are low. Stage of cancer is an important factor influencing survival of patients with stomach cancer. Surgery is an effective treatment for the patients with stage IV cancer and can raise short- and mid-term survival rates. Total gastrectomy should not be encouraged for the patients with late stage of cancer.

China↗

PubMed2005

[Cryohepatectomy for liver cancer: preliminary evaluation of reducing postoperative recurrence].

OBJECTIVE: To determine whether cryohepatectomy is potentially beneficial in reducing the recurrence and prolonging survival for hepatocellular carcinoma (HCC). METHODS: The study included 84 patients who underwent cryohepatectomy, cryosurgery with liquid nitrogen (-196 degrees C) followed by the resection of the frozen tumor by conventional technique, for HCC and were closely follow-up after surgery. Recurrence and survival rates were calculated by the life-table method. RESULTS: The postoperative course of cryohepatectomy in all of the 84 patients was uneventful, there being no operative mortality or severe complications. The 1-, 3-, and 5-year survival rates after cryohepatectomy were 98.7%, 83.9% and 64.0%, respectively. The 1-, 3-, and 5-year recurrence rates after cryohepatectomy were 15.1%, 30.1% and 39.0%, respectively. CONCLUSIONS: Cryohepatectomy for HCC is a safe procedure and may be potentially beneficial in reducing recurrence and prolonging survival. More time is needed to further define whether this procedure will improve long-term survival as compared with conventional resection.

Adult↗

PubMed1992

A multicenter clinical trial in Nigeria with Multiload-Cu250 (MLCu250) and Multiload-Cu375 (MLCu375) intrauterine devices.

A multicenter study was conducted in Nigeria, comparing the Multiload-Cu250 (MLCu250) with the Multiload-Cu375 (MLCu375). The two intrauterine devices were studied on aspects of effectiveness and acceptability. Parameters were observed and analyzed, using the life-table method of Tietze and Lewit. Continuation rates were excellent. Overall results were in line with studies done elsewhere in the world with Multiload devices, showing a slight superiority of the MLCu375 over the MLCu250.

Female↗

PubMed1996

Renal artery reconstruction for the preservation of renal function.

PURPOSE: We reviewed a 13-year experience with an emphasis on long-term survival and renal function response when renal artery reconstruction (RAR) was performed primarily for the preservation or restoration of renal function in patients who had atherosclerotic renovascular disease. METHODS: From January 1, 1980, to June 30, 1993, 139 patients underwent RAR for renal function salvage and were retrospectively reviewed. Inclusion criteria were either preoperative serum creatinine level > 2.0 mg/dl (67% of patients) or RAR to the entire functioning renal mass irrespective of baseline renal function. Patient survival was calculated by life-table methods. Cox regression analysis was used to determine relative risk (RR) estimates for the late outcomes of continued deterioration of renal function and late survival after RAR. A logistic regression model was used to evaluate variables associated with perioperative complications. RESULTS: Clinical characteristics of the cohort were notable for advanced cardiac (history of congestive heart failure, 27%; angina, 22%; previous myocardial infarction, 19%) and renal disease (serum creatinine level < 2.0 mg/dl, 33%; 2.0 mg/dl to 3.0 mg/dl, 40%, > 3.0 mg/dl, 27%). Cardiac disease was the principle cause of early (6 of 11 operative deaths) and late death. Operative management consisted of aortorenal bypass in 47%, extraanatomic bypass in 45%, and endarterectomy in 8%; 45% of patients required combined aortic and RAR. The operative mortality rate was 8%; significant perioperative renal dysfunction occurred in 10%. Major operative morbidity was associated with increasing azotemia (RR = 2.1; p = 0.001; 95% confidence interval [CI], 1.3 to 4.7 for each 1.0 mg/dl increase in baseline creatinine level). Of those patients who had a baseline creatinine level > or = 2.0 mg/dl, 54% had > or = 20% reduction in creatinine level after RAR. Late follow-up data were available for 87% of operative survivors at a mean duration of 4 years (range, 6 weeks to 12.6 years). Actuarial survival at 5 years was 52% +/- 5%. Continued deterioration in renal function occurred in 24% of patients who survived operation, and eventual dialysis was required in 15%. Deterioration of renal function after RAR was associated with increasing levels of preoperative creatinine (RR = 1.6; 95% CI, 1.2 to 1.8; p = 0.001 for each 1.0 mg/dl increment in baseline creatinine level), and inversely related to early postoperative improvement in creatinine level (RR = 0.41; 95% CI, 0.2 to 0.9; p = 0.04). CONCLUSIONS: Intervention before major deterioration in renal function and an aggressive posture toward the frequently associated coronary artery disease are necessary to improve long-term results when RAR is performed for renal function salvage.

Adult↗

PubMed1998

Outcome after 'curative' surgery for carcinoma of the lower third of the rectum.

BACKGROUND: Controversy exists about the optimal surgical resection for lower third rectal carcinoma. The aim of this retrospective study was to analyse whether the type of surgery is a significant predictor of outcome after curative surgery alone. METHODS: Eighty-two consecutive patients underwent abdominoperineal rectum excision (APRE, 41 patients) or sphincter-saving operation (SSO, 41 patients) for adenocarcinoma at 3.5-7.5 cm from the anal margin. Cox proportional hazards technique with univariate and corrected (multivariate) analyses and the Kaplan-Meier life-table method were used to evaluate the data. RESULTS: Tumour wall penetration and lymph node involvement, but not the tumour level or the type of surgery, were found to be significant predictors of outcome. The local recurrence rate at 1, 2 and 5 years was 10, 22 and 26 per cent respectively after APRE, and 5, 13 and 21 per cent after SSO. The disease-free survival rate at 1, 2 and 5 years was 85, 67 and 58 per cent respectively after APRE, and 88, 78 and 62 per cent after SSO. CONCLUSION: Tumour-related factors are significant predictors of outcome. The type of surgery (APRE or SSO) did not seem to be a significant variable in this non-randomized study.

Adenocarcinoma↗

PubMed1979

Comparative method for actuarial analysis of cardiac valve replacements.

The use of survival analysis in cardiac surgical reports has been widely accepted in order to characterise and compare performances of different valve prostheses. However, the analyses that have been described elsewhere may be improved in several respects. The original method proposed for prosthetic valve evalation examined follow-up related to patients rather than the valves themselves and therefore neglected the possibility of factors other than the valve itself which could affect the fate of cardiac patients. Furthermore, there has not yet been any application of life table methods to compare two different sets of data, or to estimate the average time before an event occurs. The present work defines valve function and malfunction and separates patient survival from valve performance. We define statistical indices, namely the median remaining lifetime and the instantaneous decrement rate. Both indices can be useful; the former measures the average survival time and the latter focuses attention on the intensity of risk changes. Using established statistical theory we calculate the significance level of difference between two independent survival rates. We qualify the presentation of probabilities with a statement of the associated standard errors.

Actuarial Analysis↗

PubMed2004

Primary cardiac tumours: eighteen years of surgical experience on 21 patients.

BACKGROUND: The literature on primary cardiac tumours is relatively limited because of their rare occurrence. OBJECTIVE: To report the authors' experience with primary cardiac tumours at McGill University teaching hospitals, Montreal, Quebec. In addition, four exceedingly rare primary cardiac tumours are presented--three valve myxomas and the seventh reported case of a primary synovial sarcoma. METHODS: Twenty-one patients resected for primary cardiac tumours were retrospectively reviewed in terms of their clinical presentation, surgical treatment, histopathological findings and outcome. Postoperative success was defined by disease-free survival after resection. A survival analysis was performed using the Kaplan-Meier life-table method. RESULTS: The mean age at the time of resection was 45.5 years (range birth to 74 years). The most common clinical presentation in adults was dyspnea (38%) or central nervous system/embolic phenomena (24%), and in the pediatric group, it was hypoxia (50%). All but one of the tumours were visualized using transthoracic echocardiography. Coronary angiography was performed in 11 patients, with a diagnosis of coronary artery disease in five patients (45%), all of whom underwent coronary artery bypass grafting. The surgical approach was uniatrial in 10 patients (48%)--seven (33%) via the left atrium and three (14%) via the right atrium. Eight patients (38%) required a biatrial approach; the remaining three patients (14%) with ventricular tumours required a ventricular approach. Of the 21 cases, 17 were adults and four were pediatric cases. There were 16 myxomas (76%), two rhabdomyomas (10%), one fibroma (5%), one angiosarcoma (5%) and one synovial sarcoma (5%). In adults, myxoma was the most common primary cardiac tumour (88%), whereas rhabdomyoma occurred most frequently in the pediatric population (50%). Three valve myxomas, two involving the mitral valve and one involving the tricuspid valve, were encountered; all underwent conservative leaflet resection and valve repair. The probability of disease-free survival for all patients was 80.7% (95% CI 63.6 to 97.7) at one year, and 75.6% (95% CI 57.0 to 94.3) at both five and 10 years after resection. For adult benign tumours, the probability of disease-free survival was 93% (95% CI 79.4 to 100.0) at one, five and 10 years. There was a total of five deaths. CONCLUSIONS: The results suggest that complete surgical resection of primary cardiac tumours prolongs symptom-free survival and is associated with a low recurrence rate. Benign primary cardiac tumours have an excellent prognosis in the adult population compared with in the pediatric population (93% versus 50% survival, respectively, in the present cohort). Furthermore, conservative leaflet resection with valve repair of valve myxomas, rather than radical excision and valve replacement, should be strongly considered. Early identification and diagnosis of primary cardiac tumours are necessary for expeditious surgical resection if a cure is desired, especially when encountering malignant primary cardiac sarcomas.

Adolescent↗

PubMedDate not supplied

Clinical study of Multiload Cu375 in Pakistan.

Three hundred and sixty five volunteers were observed for a total of 4882 woman-months for the clinical evaluation of MLCu375. Data were analyzed by life-table method at 6, 12 and 18 months. Most women were 21-30 years old, and of parity 2-4. Continuation rates of 78.2 and 68.8 at 12 and 18 months, respectively, and a pregnancy rate of 0.3% proved the device to be highly effective and well tolerated.

Adolescent↗

PubMed2004

Long-term outcome of renal transplant recipients in the United States after coronary revascularization procedures.

BACKGROUND: Retrospective studies in dialysis patients have reported increased survival after coronary artery bypass (CAB) compared with coronary artery stenting and PTCA. The purpose of this study was to compare the long-term outcome of renal transplant recipients after stent, PTCA, or CAB with or without internal mammary grafting (CAB [IMG+] or CAB [IMG-]). METHODS AND RESULTS: Renal transplant recipients hospitalized from 1995 to 1999 for first coronary revascularization procedure were retrospectively identified from the United States Renal Data System database. Event-free survival for the end points of all-cause death, cardiac death, acute myocardial infarction (AMI), and the combined end point of cardiac death or AMI was estimated by the life-table method. The impact of independent predictors on survival was examined in a comorbidity-adjusted Cox model. In-hospital mortality rate was 2.3% for 909 stent patients, 4.3% for 652 PTCA patients, 9.4% for 288 CAB (IMG-) patients, and 5.0% for 812 CAB (IMG+) patients. Two-year all-cause survival (+/-SE) was: stent, 82.5+/-2.8%; PTCA, 81.6+/-3.1%; CAB (IMG-), 74.4+/-5.4%; and CAB (IMG+), 82.7+/-2.8%. The relative risks of all-cause and cardiac death were not significantly different among revascularization groups. The relative risk of cardiac death or AMI (versus PTCA) was 0.90 (95% CI, 0.69 to 1.17) for stent, 0.80 (95% CI, 0.55 to 1.17) for CAB (IMG-), and 0.57 (95% CI, 0.42 to 0.76) for CAB (IMG+). CONCLUSIONS: Renal transplant recipients in the United States have comparable long-term survival after percutaneous and surgical coronary revascularization procedures. The most favorable long-term outcome occurs after surgical coronary revascularization.

Adult↗

PubMed2001

Results of surgical resection of patients with primary lung cancer: a retrospective analysis of 1,905 cases.

BACKGROUND: Surgical resection, combined therapies, and lymphadenectomy are extensively utilized in the treatment of patients with lung cancer. In the present study, we summarized the clinical data of patients with primary lung cancer after surgical resection alone or combined with adjuvant therapy, and evaluate the main factors influencing long-term survival. METHODS: A retrospective review of 1,905 consecutive patients with primary lung cancer treated at the Cancer Institute of the Chinese Academy of Medical Sciences from March 1961 through December 1995 was performed. Statistical analysis was done using STATA software. The survival rate was estimated using the life-table method. Survival differences were performed using the log-rank test. The modified 1997 TNM staging system was used. RESULTS: There was a 12.28% morbidity rate and a 1.31% hospital mortality in our series. The 5-year survival rate for the complete resection was 49.5% and for the palliative resection 18.8% (p < 0.01). The 5-year survival rate was 72.0% in stage IA and 61.0% in stage IB (p < 0.05), 32.9% in stage IIA and 34.5% in stage IIB, 22.6% in stage IIIA and 15.9% in stage IIIB (p < 0.05), and 7.1% in stage IV. CONCLUSIONS: Multiple factors influence the long-term survival of patients with primary lung cancer after surgery. They include TNM staging, the extent of surgical resection (complete or palliative), resection margin (positive or negative), pathologic type of tumors, and type of resection.

Adult↗

PubMed1998

Clinical significance of Philadelphia chromosome positive pediatric acute lymphoblastic leukemia in the context of contemporary intensive therapies: a report from the Children's Cancer Group.

BACKGROUND: Children with Philadelphia (Ph) chromosome positive (+) acute lymphoblastic leukemia (ALL) represent a subgroup at very high risk for treatment failure. In this report, the authors assessed the outcome of Ph+ ALL in a large cohort of children treated on contemporary intensive chemotherapy protocols of the Children's Cancer Group (CCG). METHODS: This study included 1322 children enrolled between 1988-1995 on CCG risk-adjusted studies for ALL who had centrally reviewed cytogenetic data. Thirty patients had a t(9;22)(q34;q11) translocation and were referred to as Ph+; 1292 were Ph negative(-). Outcome analyses used standard life table methods. RESULTS: Compared with Ph- ALL patients, Ph+ ALL patients were more likely to be black (P=0.008), age >10 years (P=0.02), and have a leukocyte count > or =50,000/L (P <0.0001). Nearly all Ph+ (96.7%) and Ph (98.3%) patients achieved remission after induction therapy, yet event free survival outcome was significantly worse for Ph+ patients compared with Ph- patients, with 4-year estimates of 20.1% (standard deviation [SD] = 9.1%) and 75.8% (SD =1.2%), respectively (P <0.0001). This difference was maintained among patients regardless of presenting leukocyte count, age, or early response to therapy. Ten Ph+ patients underwent bone marrow transplantation (BMT) at the time of first remission; six of these patients remained event free at the time of analysis, and represent the majority (six of eight) of patients surviving event free. CONCLUSIONS: The findings of the current study confirm that Ph chromosome positivity represents a significant independent adverse risk factor for childhood ALL that has not been abrogated by current intensive chemotherapy programs. BMT at the time of first remission, as well as other alternative strategies employing biotherapeutic agents, should be considered in future front-line trials for pediatric patients with Ph+ ALL.

Bone Marrow Transplantation↗

PubMed1991

Efficacy of laparoscopic electrocoagulation in infertile patients with minimal or mild endometriosis.

The cumulative pregnancy rates in 17 infertile patients with minimal or mild endometriosis who underwent laparoscopic electrocoagulation were compared with those of 20 similar patients who underwent only diagnostic laparoscopy. A life-table method of analysis was used. No significant differences in pregnancy rates was evident at either 6 months (p greater than 0.5) or 12 months (p greater than 0.5) of follow-up. These results question the use of laparoscopic electrocoagulation for the treatment of infertile patients with minimal or mild endometriosis.

Adult↗

PubMed1995

Shunt failure in adult hydrocephalus: flow-controlled shunt versus differential pressure shunts--a cooperative study in 289 patients.

BACKGROUND: In order to assess the efficiency of flow-controlled shunts in reducing shunt failure in the treatment of adult hydrocephalus (with a special focus on overdrainage complications), a series of 289 patients was analyzed through a retrospective and comparative study performed in three neurosurgical departments. METHODS: A group of 142 adult patients suffering from hydrocephalus were operated on using a conventional differential pressure (DP) shunt and compared with a group of 147 adult patients operated on using flow-controlled (FC) system (Orbis-Sigma, Cordis). Only the first complication, which required a surgical revision within the first 2 years after shunt implantation, was taken into account for each patient and analyzed using life-table methods. RESULTS: The actuarial risk of shunt infection in the two groups is respectively 8.3% and 10.9% at 1 year (nonsignificant difference). The actuarial risk of mechanical complications at 1 year is 38% for the DP patients and 10% for the FC patients (p = 0.0001); this difference is largely due to a decrease of complications related to overdrainage phenomenon (14/142 subdural collections were observed in the DP group versus 1/147 in the FC group) (p = 0.0001). CONCLUSION: The conclusion of this cooperative and retrospective study is that the use of a flow-controlled system decreases the risk of mechanical complications related to the hydrodynamic properties of the shunts used in the treatment of adult hydrocephalus, especially those related to overdrainage.

Adolescent↗

PubMed2001

Impact of increasing comorbidity on infrainguinal reconstruction: a 20-year perspective.

OBJECTIVE: To examine trends in patient and procedural variables and outcomes associated with autogenous lower extremity arterial reconstruction (LER) in a single center during a period of two decades. SUMMARY BACKGROUND DATA: Surgical arterial reconstruction is of proven value in the therapy of patients with critical ischemia of the lower extremities. Changing demographics and increasing comorbidity are resulting in an increasing prevalence and associated complexity of peripheral vascular disease. The effect of these variables on the types and outcomes of surgical reconstructions is not known. METHODS: The authors performed a retrospective analysis of all autogenous LER procedures performed at their institution from 1978 to 1997. Procedures were divided into 5-year intervals: group 1, 1978 to 1982; group 2, 1983 to 1987; group 3, 1988 to 1992; group 4, 1993 to 1997. Categorical parameters were compared using chi-square analysis; rates were computed by the life-table method and compared using Mantel-Cox log-rank analysis. RESULTS: A total of 1,642 autogenous LER procedures were performed in 1,274 patients. A significant increase in age, female gender, diabetes mellitus, renal failure, and prior coronary artery bypass grafting was noted in group 4. Increased technical complexity in this group was reflected by a greater incidence of tissue necrosis as the indication for LER, the use of ectopic or composite vein, and more distal levels of outflow. The surgical death rate remained unchanged (2%) throughout. Patient survival, primary and secondary graft patency, and limb salvage at 5 years for the entire cohort were 70 +/- 2%, 63 +/- 2%, 73 +/- 1%, and 85 +/- 1%, respectively. Hospital length of stay was reduced 25% from a mean of 15.7 +/- 0.8 days in group 3 to 11.7 +/- 0.4 days in group 4. CONCLUSION: In a tertiary practice setting, patients requiring LER present an increasingly complex medical and surgical challenge compared with the previous decade. Excellent outcomes may still be achieved by an aggressive approach relying on autogenous vein conduit.

Aged↗

PubMed1995

Prognostic significance in malignant melanoma of nuclear DNA content measured by a microfluorimetric method.

The nuclear DNA content of 47 primary malignant melanomas was measured by 4',6-diamidino-2-phenylindole-DNA (DAPI-DNA) microfluorimetry, and the DNA index, a quantitative measure of nuclear DNA content, was calculated. The DNA index and other clinical and pathological variables were examined and compared with patient survival using univariate and multivariate analyses. The Kaplan-Meier life table method revealed that the DNA index and metastases to regional lymph nodes significantly correlated with patient survival. A Cox proportional hazards multivariate analysis demonstrated that the DNA index, which was not significantly correlated with other variables, was the most reliable and independent factor for predicting patient survival.

Adult↗

PubMed2000

The snuffbox arteriovenous fistula for vascular access.

OBJECTIVES: to determine the applicability, patency rates and factors influencing patency of snuffbox arteriovenous fistulae for haemodialysis access. DESIGN: retrospective non-randomised study. MATERIALS AND METHODS: patency was determined by reference to an ongoing database and dialysis records of 645 vascular access procedures between 1985 and 1997, including 210 snuffbox fistulae in 201 patients. RESULTS: snuffbox fistulae comprised 189/376 (50%) primary procedures. Records of 208 snuffbox fistulae were available for patency analysis by the life-table method. Twenty-two (11%) thrombosed within 24 hours of operation. After six weeks 80% were used for dialysis. Cumulative patency was 65% at 1 year and 45% at 5 years. After thrombosis of snuffbox fistulae, ipsilateral wrist fistulae could be constructed in 45%. Fistula patency was significantly better in men than women (p<0.001) and for left- than right-sided fistulae (p<0.001). Diabetes, age >70 years, and the prior commencement of haemodialysis did not significantly affect fistula survival. CONCLUSIONS: the snuffbox AV fistula gives a long segment of arterialised vein for needling and preserves proximal vessels. It is feasible in 50% of patients requiring primary access and has good long-term patency, especially in men. A more proximal fistula may be preferable in women with smaller vessels.

Arteriovenous Shunt, Surgical↗