Evidence map›Paper›PMID 42754529›Full record

ArticleThe Korean journal of internal medicine2026

Mortality risk associated with permanent central venous catheter use in the oldest-old population: a nationwide cohort study.

Joo Un Park, Chang Min Park, Do Hyoung Kim, Hyangkyoung Kim, Byung Ha Chung, Hyung Seok Lee, Sang Jun Park, Min-Ho Kim, Hoon Suk Park

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In one paragraph

Article in The Korean journal of internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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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

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Joo Un ParkDivision of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Chang Min ParkDivision of Nephrology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
Do Hyoung KimDivision of Nephrology, Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Hyangkyoung KimDivision of Vascular Surgery, Department of Surgery, Ewha Womans University Medical Center, Ewha Womans University College of Medicine, Seoul, Korea.
Byung Ha ChungDivision of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Hyung Seok LeeDivision of Nephrology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
Sang Jun ParkDivision of Vascular Surgery, Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Min-Ho KimEwha Medical Data Organization, Ewha Womans University Seoul Hospital, Seoul, Korea. mino-kim@naver.com.
Hoon Suk ParkDivision of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. cttailor@catholic.ac.kr.

Funding

Catholic Medical Center Research FoundationKorean society of dialysis access
6 · The paper itself

Abstract

BACKGROUND/

aimsOwing to aging-related factors, arteriovenous access (AV) is difficult to establish in older patients; central venous catheter (CVC) access is used instead. However, evidence on long-term outcomes of permanent vascular access types in the oldest-old adults (≥ 80 yr) is lacking. We aimed to compare mortality by vascular access type in older Korean patients undergoing hemodialysis.

methodsThis nationwide retrospective cohort study included 79,286 adult patients who initiated maintenance hemodialysis between 2012 and 2021, identified from the Korean National Health Insurance Service database. Patients were categorized by permanent vascular access type (AV fistula [AVF], AV graft [AVG], or CVC). Kaplan-Meier survival analysis and Cox proportional hazards models were used to assess mortality across vascular access types. Analyses were stratified by age group.

resultsCVC access was associated with the highest mortality. Compared with AVF use, CVC use was associated with more than a threefold increase in mortality risk (aHR 3.54; 95% CI, 3.43-3.65). Though attenuated, the CVC use-associated mortality risk remained significantly elevated in octogenarians and nonagenarians (aHR 3.30; 95% CI, 3.14-3.47 and aHR 3.18; 95% CI, 2.65-3.82, respectively). Compared with AVG use, CVC use remained consistently associated with elevated mortality risk across age groups.

conclusionCVC use as permanent access was associated with increased mortality, even among the oldest-old. Advanced age should be regarded as a clinical consideration rather than a definitive contraindication to AV access. Our findings support the need for individualized clinical decision-making, even in the oldest-old population.

Indexed as

Arteriovenous Shunt, SurgicalCatheterization, Central VenousCentral Venous CathetersKidney Failure, ChronicRenal DialysisAged, 80 and overAge FactorsDatabases, FactualFemaleHumansMaleRepublic of KoreaRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsAgedArteriovenous shunt, surgicalCentral venous cathetersMortalityRenal dialysis

Identifiers

PMID42754529
PMCPMC13585701

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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.