Comparación de dos métodos de seguimiento de las fístulas arteriovenosas protésicas incidentes en un área de salud

vascular access (va) is an important challenge, on which the patient's quality of life depends. object: to find out whether a computerize va monitoring programme reduces the rate of thrombosis of incident prosthetic avf (ip-avf). material and methods: observational prospective study of ip-avf monitoring, between 2007 and 2009, in area 8 of the cam. nursing recorded on an access database: dynamic venous pressure, negative arterial pressure and pump flow in the first hour of dialysis. we compared the results with a historical control group (hcg) of ip-avf from 2004-2006, when data were only recorded on the nursing chart. ip-avf thrombosis after 2006 was not valued. results: diabetes, sex and age were not related to thrombosis in any group. ip-avfs at risk in 2007-2009 were: 49 v. 45 of the hcg. we compared the results for the period 2007-2009 compared to the hcg: annual thrombosis rate: 0.37(18/49) v. 0.67(30/45), (p<0.003). median first episode of thrombosis 217 v.167 days. annual rate of fistulographies due to dysfunction 0.98(48/49) v. 0.51(23/45), (p<0.000). positive predictive value: 94% v. 87%. sensitivity: 82% v. 44%. diagnosed stenoses 45 v. 20. annual repair rate for dysfunction: 0.80(39/49) v. 0.31(14/45), (p<0.000). annual repair rate before first thrombosis: 0.41(7/17) v. 0.19(4/21), (p<0.001). annual repair rate for thrombosis: 0.43(21/49) v. 0.69(31/45), (0.01). through the computerized recording of va parameters, nurses contribute to diagnosing pre-thrombosis events in ip-avfs, increasing the number of preventive repairs for dysfunction and reducing the rate of thrombosis.