Risk factors for early onset peritonitis: the SCOPE collaborative

Keswani, Mahima; Mahon, Allison C Redpath; Richardson, Troy; Rodean, Jonathan; Couloures, Olivera Marsenic; Martin, Abigail; Blaszak, Richard T.; Warady, Bradley A.; Neu, Alicia M.; Investigators, Scope

doi:10.1007/s00467-019-04248-0

Cited by 22 publications

(5 citation statements)

References 13 publications

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“…In a recent multicenter collaborative cohort study from USA, the incidence of early PD peritonitis (defined as peritonitis within 60 days of insertion of a catheter) was 8.4%. [ 17 ] The incidence of early PD peritonitis (within 3 months) in our study was also relatively low (4.9%) and comparable among the three groups. This is in contrast to a recent Turkish study, in which the authors found a significant higher rate of peritonitis in open insertion (75%) compared with laparoscopic insertion (25%).…”

Section: Discussionsupporting

confidence: 62%

Does laparoscopic omentectomy reduce CAPD catheter malfunction: A three-arm pilot randomized trial

et al. 2022

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Introduction: Catheter malfunction secondary to omental wrapping is a frequent complication of continuous ambulatory peritoneal dialysis (CAPD). Of the various methods of peritoneal dialysis catheter insertion (PDCI), open surgical insertion under local anesthesia is most widely practiced. Laparoscopic omentectomy is often undertaken as a salvage procedure in case of malfunctioning catheters. However, there is no randomized controlled trial (RCT) to evaluate the role of prophylactic laparoscopic omentectomy on catheter function. This pilot RCT was undertaken to evaluate the impact of laparoscopic omentectomy on the incidence of catheter malfunction. Materials and Methods: Consecutive patients were randomized into three groups: laparoscopic PDCI with omentectomy (Group A), laparoscopic PDCI without omentectomy (Group B) and open surgical PDCI (Group C). The primary outcome was the incidence of catheter malfunction at 6 weeks and 3 months. Results: Forty-one patients completed follow-up, with 16, 11, and 14 patients in Groups A, B, and C, respectively. Incidence of catheter malfunction was 6.2%, 27.3%, and 14.3% in Groups A, B, and C, respectively, at 6 weeks and 6.2%, 36.4%, and 21.4% at 3 months, respectively. In patients with previously failed catheter insertion ( n = 23), malfunction at 3 months was 8.3% (1/12) in patients who had omentectomy, compared with 45.5% (5/11) in those who did not ( P = 0.069). Operating time was significantly higher ( P < 0.001) in Group A. Conclusions: Laparoscopic omentectomy may be associated with a lower incidence of catheter malfunction, especially in patients with previously failed peritoneal dialysis catheter. Data from this pilot RCT can be used to design a large trial with an adequate number of patients.

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Section: Discussionsupporting

confidence: 62%

Does laparoscopic omentectomy reduce CAPD catheter malfunction: A three-arm pilot randomized trial

et al. 2022

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“…EOP is more strongly associated with multiple PDAP and technique failure than LOP in a pediatric population [33], and EOP was a risk factor for mortality in elderly PD patients [12]. The increased risk of EOP in elderly patients may be due to impaired vision and decreased physical and mental health [34].…”

Section: Discussionmentioning

confidence: 99%

Poorer clinical outcomes of early‐onset peritonitis in elderly peritoneal dialysis patients: A longitudinal and multicenter study

Guo

Chen

Wu³

et al. 2021

Ther Apher Dial

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Introduction: Early-onset peritonitis (EOP) is a risk factor for mortality in peritoneal dialysis (PD) patients. This study investigates the clinical features and outcomes of EOP in elderly patients. Methods: This multicenter retrospective study evaluated 433 elderly PD patients with end-stage renal disease. The cohort was divided into nonperitonitis group (n = 239), EOP group (≤12 months, n = 109) and late-onset peritonitis (LOP) group (>12 months, n = 85). Clinical data, treatment results, and outcomes were compared between the groups.Results: Compared with LOP group, there were no significant intergroup differences in the rate of primary recovery, complete cure, relapse, catheter removal, or death from PDAP (p >0.05) in the most recent PDAP episode. However, Kaplan-Meier analysis showed that patients in the EOP group were likely to have multiple episodes of PD-associated peritonitis (PDAP), technique failure, all-cause death, and composite endpoint in the long-term prognostic outcomes (p <0.001).Conclusions: EOP is significantly associated with poorer clinical outcomes in older PD patients. K E Y W O R D Searly-onset peritonitis, elderly peritoneal dialysis patients, outcomes, peritoneal dialysisassociated peritonitis

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“…In this effort, mean monthly peritonitis rates across 24 centers decreased from 0.63 episodes per patient year before launch of the standardized bundle to 0.42 at 36 months after launch [ 32 ]. Additionally, the SCOPE collaborative has reported epidemiologic data to describe exit site and tunnel infection rates for children on peritoneal dialysis [ 33 ] and risk factors for early onset peritonitis [ 34 ] and fungal peritonitis [ 35 ]—data that is critical in the work to improve such outcomes.…”

Section: Learning Health Network In Pediatric Nephrologymentioning

confidence: 99%

The learning health system for pediatric nephrology: building better systems to improve health

et al. 2022

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Learning health systems (LHS) align science, informatics, incentives, and culture for continuous improvement and innovation. In this organizational system, best practices are seamlessly embedded in the delivery process, and new knowledge is captured as an integral byproduct of the care delivery experience aimed to transform clinical practice and improve patient outcomes. The objective of this review is to describe how building better health systems that integrate clinical care, improvement, and research as part of an LHS can improve care within pediatric nephrology. This review will provide real-world examples of how this system can be established in a single center and across multiple centers as learning health networks.

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Risk factors for early onset peritonitis: the SCOPE collaborative

Cited by 22 publications

References 13 publications

Does laparoscopic omentectomy reduce CAPD catheter malfunction: A three-arm pilot randomized trial

Does laparoscopic omentectomy reduce CAPD catheter malfunction: A three-arm pilot randomized trial

Poorer clinical outcomes of early‐onset peritonitis in elderly peritoneal dialysis patients: A longitudinal and multicenter study

The learning health system for pediatric nephrology: building better systems to improve health

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