Integrated management to reduce fistula-related long-term complications and improve the quality of life after arteriovenous fistula surgery: A retrospective cohort study.

It was a single centre retrospective study without randomisation, so patients assigned to different wards may have differed in ways not measured. The integrated care was a bundle of several nursing actions, so the study cannot show which component reduced complications. Outcomes were taken from routine chart data with no quality control, and the paper does not state which outcome was primary. Only patients aged 18 to 70 with normal cognition, good compliance, regular dialysis and normal coagulation and platelet indices were included, so the result may not apply to more complex patients. Patients lost to follow-up or dead within 1 year were excluded, which could bias the complication count.

The authors declare no competing interests. No funding source or sponsor role is reported in the supplied text.

Do not conclude that ultrasound mapping alone caused fewer fistula complications. The integrated group received a bundle of assessment, planned puncture, monitoring, maintenance and education, and the study was non-randomised, so the effect of any single component cannot be separated.