Abstract:
Background: Healthcare-associated infection drives morbidity and unplanned hospital use in haemodialysis. We aimed to determine whether an adapted British Renal Society Infection Risk Screening Tool, applied during a nurse-led vascular access consultation, identifies patients at increased risk of subsequent infection-related hospitalisation and can inform de-selection of buttonhole puncture.
Methods: We conducted a retrospective cohort of 404 adults reviewed between 1 January 2022 and 31 December 2024. Baseline demographics, comorbidities, vascular access status and screening classification (“risk present/absent”) were retrieved from records. The primary outcome was ≥1 infection-related hospitalisation within 12 months; the number of such admissions was secondary.
Results: Mean age was 70.2 years; 47% had diabetes; 27.8% screened “risk present”. Forty-eight patients (11.9%) were hospitalised for infection. “Risk present” showed higher-though imprecise-odds of infection-related admission versus “risk absent” (adjusted OR 1.73; 95% CI 0.90-3.27). Older age increased risk, whereas higher body-mass index appeared protective; diabetes, central venous catheter and dialysis vintage were not significant.
Conclusions: The dichotomised screening classification identified only a modest elevation in risk, with age and nutritional status exerting greater influence. The tool may support cautious de-selection of buttonhole in higher-risk individuals, but refinement and prospective validation are required.
Reference:Pinto R, Ferreira R, Alves P, Barros JP, Piedade AR, Mata F, Ferreira E, Sá H, Schoch M, Santos E. Clinical Implementation of an Adapted Infection Risk Screening Tool Following Nurse-Led Haemodialysis Vascular Access Consultation. Healthcare (Basel). 2025 Nov 26;13(23):3058. doi: 10.3390/healthcare13233058. PMID: 41373275; PMCID: PMC12691982.