Relationship between double-cuff versus single-cuff peritoneal dialysis catheters and risk of peritonitis
Bibliographic record
Abstract
BACKGROUND: Peritonitis among peritoneal dialysis (PD) patients remains an important complication. To date, no catheter type has consistently been shown to reduce peritonitis risk. It has been hypothesized that double-cuff catheters might be superior to single-cuff catheters in preventing peritonitis caused by periluminal entry of organisms. METHODS: Using data collected in the multicentre Canadian Baxter Peritonitis Organism Exit-Sites Tunnel Infections (POET) database between 1996 and 2005, the association between number of catheter cuffs and peritonitis was tested. Variables adjusted for in the negative binomial model included age, gender, race, diabetes, renal disease, transfer from haemodialysis, previous renal transplant, PD modality and swan neck versus straight catheter. RESULTS: Data were available for 4247 incident patients with a total of 2555 peritonitis episodes, corresponding to a peritonitis rate of 0.364 per dialysis year at risk. After adjustment for covariates, double-cuff catheter use was associated with a trend towards a lower peritonitis rate ratio (RR) 0.90, 95% confidence interval (CI) 0.80-1.01, P = 0.08]. This trend was largely due to a decreased Staphylococcus aureus peritonitis rate in those with a double-cuff catheter (RR 0.46, 95% CI 0.33-0.64, P < 0.001). When stratified by era of PD initiation, the benefit of double-cuff catheters was seen only among those initiating PD before 2001. CONCLUSION: Use of a double-cuff PD catheter is associated with a reduction in S. aureus peritonitis. Loss of the association between cuff number and peritonitis after the year 2000 may relate to changes in exit-site care that reduce the bacterial burden available for periluminal migration.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".