Association between systemic coagulation-inflammation index and proximal upper-extremity arteriovenous graft thrombosis in hemodialysis patients.

Abstract

Introduction: To the best of our knowledge, the potential predictive association between systemic coagulation-inflammation index (SCI) and arteriovenous graft (AVG) thrombosis following proximal upper-extremity AVG surgery has not yet been investigated. Thus, in this study, we investigated the predictive value of SCI on postoperative early-term AVG thrombosis in patients undergoing proximal upper-extremity AVG surgery for hemodialysis access.

Methods: A total of 118 hemodialysis patients undergoing proximal upper-extremity AVG surgery were enrolled to this retrospective observational cohort study. The patients were categorized into two groups in accordance with whether postoperative early-term AVG thrombosis developed; as thrombosed AVG group (n = 37) and non-thrombosed AVG group (n = 81). Basic clinical features and laboratory test results of the patients were recorded and compared between the groups.

Results: Patients in thrombosed AVG group were significantly older than those in non-thrombosed AVG group. The mean WBC and neutrophil counts were significantly lower whereas the mean fibrinogen and median SCI values were significantly higher in thrombosed AVG group compared to non-thrombosed AVG group. In terms of other basic clinical features and laboratory tests, there were no significant differences between both groups in univariate analyses. In multivariate logistic regression analysis, only age and SCI maintained their statistical significance and thus were accepted as independent predictors of AVG thrombosis. ROC analysis demonstrated that SCI of 47 g/L constituted the optimum cut-off value with 94.6% sensitivity and 88.9% specificity rates in predicting AVG thrombosis.

Conclusion: Our study revealed for the first time in the literature that SCI independently predicted postoperative early-term AVG thrombosis in hemodialysis patients undergoing proximal upper-extremity AVG surgery.