Disparities in Receipt of Bariatric Surgery in Canada: An Analysis of Data From an Ontario Bariatric Surgery Referral Center.

Background: Patients with lower socioeconomic status (SES) in the United States have reduced access to many health services including bariatric surgery. It is unclear whether disparities in bariatric surgery exist in countries with government-sponsored universal health benefits. The authors used data from a large regional Canadian bariatric surgery referral center to examine the relationship between SES and receipt of bariatric surgery.

Can Patient Selection Explain the Obesity Paradox in Orthopaedic Hip Surgery? An Analysis of the ACS-NSQIP Registry.

Background: The "obesity paradox" is a phenomenon described in prior research in which patients who are obese have been shown to have lower postoperative mortality and morbidity compared with normal-weight individuals. The paradox is that clinical experience suggests that obesity is a risk factor for difficult wound healing and adverse cardiovascular outcomes. We suspect that the obesity paradox may reflect selection bias in which only the healthiest patients who are obese are offered surgery, whereas nonobese surgical patients are comprised of both healthy and unhealthy individuals.

Complications of the Arteriovenous Fistula: A Systematic Review.

The implementation of patient-centered care requires an individualized approach to hemodialysis vascular access, on the basis of each patient's unique balance of risks and benefits. This systematic review aimed to summarize current literature on fistula risks, including rates of complications, to assist with patient-centered decision making. We searched Medline from 2000 to 2014 for English-language studies with prospectively captured data on ≥100 fistulas.

Hemodialysis Arteriovenous Vascular Access Creation After Kidney Transplant Failure.

Background: Little is known about vascular access in patients starting hemodialysis therapy after kidney transplant failure.

Study Design: Retrospective cohort study.

Setting & Participants: Adult patients (aged ≥18 years) who started hemodialysis therapy in Ontario, Canada, from January 1, 2001, through December 31, 2010, after kidney transplant failure.

Vascular access creation before hemodialysis initiation and use: a population-based cohort study.

Background And Objectives: In Canada, approximately 17% of patients use an arteriovenous access (fistula or arteriovenous graft) at commencement of hemodialysis, despite guideline recommendations promoting its timely creation and use. It is unclear if this low pattern of use is attributable to the lack of surgical creation or a high nonuse rate.

Design, Setting, Participants, & Measurements: Using large health care databases in Ontario, Canada, a population-based cohort of adult patients (≥18 years old) who initiated hemodialysis as their first form of RRT between 2001 and 2010 was studied.

Association between vascular access type and patient mortality among elderly patients on hemodialysis in Canada.

Optimal vascular access in elderly patients requires consideration of the benefits and risks in a population with increased comorbidity and mortality. Our objective was to examine the association between vascular access type and patient mortality by age category among incident adult hemodialysis patients registered in the Canadian Organ Replacement Register between 2001 and 2010. We also describe the secular trend in incident and prevalent vascular access use.

Patency rates of the arteriovenous fistula for hemodialysis: a systematic review and meta-analysis.

Background: Advantages of the arteriovenous fistula (AVF), including long patency and few complications, were ascertained more than 2 decades ago and may not apply to the contemporary dialysis population.

Study Design: Systematic review and meta-analysis. Estimates were pooled using a random-effects model and sources of heterogeneity were explored using metaregression.