Evidence map›Paper›PMID 41616877›Full record

ArticleJournal of vascular surgery2026

The association between multimorbidity and arteriovenous fistula creation outcomes.

Jose L Lopez, Theodore H Yuo, Mehrnaz Siavoshi, Alejandro A Vega, Christine M Mavilian, Sahana Ravishankar, Melissa Y Wei, Vincent L Rowe, Karen Woo

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of vascular surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jose L LopezDepartment of Surgery, Division of Vascular Surgery, University of California Los Angeles, Los Angeles, CA.
Theodore H YuoDepartment of Surgery, Division of Vascular Surgery, University of Pittsburgh, Pittsburgh, PA.
Mehrnaz SiavoshiDepartment of Urology, University of California Los Angeles, Los Angeles, CA.
Alejandro A VegaDepartment of Surgery, Division of Vascular Surgery, University of California Los Angeles, Los Angeles, CA.
Christine M MavilianDepartment of Surgery, Division of Vascular Surgery, University of California Los Angeles, Los Angeles, CA.
Sahana RavishankarDepartment of Surgery, Division of Vascular Surgery, University of California Los Angeles, Los Angeles, CA.
Melissa Y WeiDepartment of Medicine, Division of General Internal Medicine and Health Services Research, University of California Los Angeles, Los Angeles, CA.
Vincent L RoweDepartment of Surgery, Division of Vascular Surgery, University of California Los Angeles, Los Angeles, CA.
Karen WooDepartment of Surgery, Division of Vascular Surgery, University of California Los Angeles, Los Angeles, CA. Electronic address: kwoo@mednet.ucla.edu.

Funding

Improving the patient experience of hemodialysis vascular access decision makingR01DK129810 · NIDDK · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Karen Woo · 2022 to 2026
$2.1M
New EHR-based multimorbidity index for diverse populations across the lifespan: development, validation, and applicationR01AG083370 · NIA · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI WEI, MELISSA · 2023 to 2025
$1.8M
NIA NIH HHS R01 AG083370NIDDK NIH HHS R01 DK129810
6 · The paper itself

Abstract

objectiveThe multimorbidity weighted index (MWI) quantifies both cumulative disease burden and its impact on physical functioning. This study examined the association between MWI and short-term outcomes of arteriovenous fistula (AVF) creation for hemodialysis access.

methodsWe performed a retrospective review of AVFs created between January 2011 and December 2019 of national Vascular Quality Initiative data linked to United States Renal Data Systems data. The primary exposure was multimorbidity as measured by the MWI. The MWI was dichotomized as above or below the median. The primary outcome was functional AVF use within 6 months. Multivariable logistic regression was performed with age, sex, race, cannulation site, and MWI as covariates.

resultsA total of 9023 patients were included. The mean age was 65 years and the cohort was predominantly male and identified as White. The median follow-up was 14 months (interquartile range, 3-33 months). The median MWI was 8.3. Of the 9023 AVF created, 5578 (61.8%) were used within 6 months of creation, and the median time to first use was 4 months (interquartile range, 3-5 months). Upper arm AVFs were more likely to be used within 6 months than forearm (62.7% vs 59.4%; P = .004). Of the 5578 patients who used their access within 6 months, 2199 (39.4%) required at least one revision before first AVF use, with most undergoing one (73.8%) or two (21.3%) revisions. Patients with an MWI greater than the median (>MED) compared with patients with MWI less than or equal to the median (<MED) were less likely to use their AVF within 6 months (58.9% vs 64.6%; P < .001) and more likely to undergo revision before first AVF use (43.2% vs 36.2%; P < .001). The median survival was shorter for patients in >MED (35 months vs 50 months; P < .001). On multivariable analysis, MWI >MED, female sex, Black race, and age >80 years were associated with a decreased odds of AVF use within 6 months. An MWI >MED, female sex, Asian and Black race, and upper arm cannulation site were associated with an increased odds of undergoing a revision before first AVF use.

conclusionsPatients undergoing AVF creation have a high MWI. In this cohort, a higher MWI was associated with increased mortality, a lower likelihood of AVF use within 6 months, and greater odds of revision before first AVF use. The MWI may be a valuable adjunct to guide vascular access planning and shared decision-making.

Indexed as

Arteriovenous Shunt, SurgicalMultimorbidityRenal DialysisAgedDatabases, FactualFemaleHumansMaleMiddle AgedRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeUnited StatesArteriovenous fistulaDialysisMultimorbidityRenal dialysis

Identifiers

PMID41616877
PMCPMC13271176

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.