Screening for dialysis access graft malfunction: comparison of physical examination with US

Scott O. Trerotola; Paul J. Scheel; Neil R. Powe; Carol Prescott; Nancy Feeley; Jiang He; Alan Watson

doi:10.1016/S1051-0443(96)70726-1

Screening for dialysis access graft malfunction: comparison of physical examination with US

Scott O. Trerotola, Paul J. Scheel, Neil R. Powe, Carol Prescott, Nancy Feeley, Jiang He, Alan Watson

School of Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

PURPOSE: To test the reliability and performance of two physical diagnosis algorithms for use in physical examination of vascular access grafts. MATERIALS AND METHODS: Grafts were assessed in 39 patients by means of physical examination performed by four observers. Grafts were characterized as having a thrill, pulse, or indeterminate examination at three locations (arterial, midpoint, venous). Findings with this algorithm were compared with those from ultrasound (US) with volume flow measurements. RESULTS: Patients with a thrill at all three locations of the graft all had volume flows greater than 450 mL/min (negative predictive value = 100%). Of patients with a pulse at any of the three locations, only 28% (positive predictive value) had a volume flow of 450 mL/ min or less. CONCLUSION: Physical examination is a good screening test for ruling out the low flows associated with impending access graft failure, thereby eliminating the need for routine US for many patients.

Original language	English (US)
Pages (from-to)	15-20
Number of pages	6
Journal	Journal of Vascular and Interventional Radiology
Volume	7
Issue number	1
DOIs	https://doi.org/10.1016/S1051-0443(96)70726-1
State	Published - Jan 1 1996

Keywords

Dialysis, shunts
Ultrasound (US), comparative studies

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging
Cardiology and Cardiovascular Medicine

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title = "Screening for dialysis access graft malfunction: comparison of physical examination with US",

abstract = "PURPOSE: To test the reliability and performance of two physical diagnosis algorithms for use in physical examination of vascular access grafts. MATERIALS AND METHODS: Grafts were assessed in 39 patients by means of physical examination performed by four observers. Grafts were characterized as having a thrill, pulse, or indeterminate examination at three locations (arterial, midpoint, venous). Findings with this algorithm were compared with those from ultrasound (US) with volume flow measurements. RESULTS: Patients with a thrill at all three locations of the graft all had volume flows greater than 450 mL/min (negative predictive value = 100%). Of patients with a pulse at any of the three locations, only 28% (positive predictive value) had a volume flow of 450 mL/ min or less. CONCLUSION: Physical examination is a good screening test for ruling out the low flows associated with impending access graft failure, thereby eliminating the need for routine US for many patients.",

keywords = "Dialysis, shunts, Ultrasound (US), comparative studies",

author = "Trerotola, {Scott O.} and Scheel, {Paul J.} and Powe, {Neil R.} and Carol Prescott and Nancy Feeley and Jiang He and Alan Watson",

year = "1996",

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doi = "10.1016/S1051-0443(96)70726-1",

language = "English (US)",

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pages = "15--20",

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TY - JOUR

T1 - Screening for dialysis access graft malfunction

T2 - comparison of physical examination with US

AU - Trerotola, Scott O.

AU - Scheel, Paul J.

AU - Powe, Neil R.

AU - Prescott, Carol

AU - Feeley, Nancy

AU - He, Jiang

AU - Watson, Alan

PY - 1996/1/1

Y1 - 1996/1/1

N2 - PURPOSE: To test the reliability and performance of two physical diagnosis algorithms for use in physical examination of vascular access grafts. MATERIALS AND METHODS: Grafts were assessed in 39 patients by means of physical examination performed by four observers. Grafts were characterized as having a thrill, pulse, or indeterminate examination at three locations (arterial, midpoint, venous). Findings with this algorithm were compared with those from ultrasound (US) with volume flow measurements. RESULTS: Patients with a thrill at all three locations of the graft all had volume flows greater than 450 mL/min (negative predictive value = 100%). Of patients with a pulse at any of the three locations, only 28% (positive predictive value) had a volume flow of 450 mL/ min or less. CONCLUSION: Physical examination is a good screening test for ruling out the low flows associated with impending access graft failure, thereby eliminating the need for routine US for many patients.

AB - PURPOSE: To test the reliability and performance of two physical diagnosis algorithms for use in physical examination of vascular access grafts. MATERIALS AND METHODS: Grafts were assessed in 39 patients by means of physical examination performed by four observers. Grafts were characterized as having a thrill, pulse, or indeterminate examination at three locations (arterial, midpoint, venous). Findings with this algorithm were compared with those from ultrasound (US) with volume flow measurements. RESULTS: Patients with a thrill at all three locations of the graft all had volume flows greater than 450 mL/min (negative predictive value = 100%). Of patients with a pulse at any of the three locations, only 28% (positive predictive value) had a volume flow of 450 mL/ min or less. CONCLUSION: Physical examination is a good screening test for ruling out the low flows associated with impending access graft failure, thereby eliminating the need for routine US for many patients.

KW - Dialysis, shunts

KW - Ultrasound (US), comparative studies

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Screening for dialysis access graft malfunction: comparison of physical examination with US

Abstract

Keywords

ASJC Scopus subject areas

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