Analysis of risk factors for central venous port failure in cancer patients

AIM: To analyze the risk factors for central port failure in cancer patients administered chemotherapy, using univariate and multivariate analyses. METHODS: A total of 1348 totally implantable venous access devices (TIVADs) were implanted into 1280 cancer patients in this cohort study. A Cox proportional hazard model was applied to analyze risk factors for failure of TIVADs. Log-rank test was used to compare actuarial survival rates. Infection, thrombosis, and surgical complication rates (χ2 test or Fisher's exact test) were compared in relation to the risk factors. RESULTS: Increasing age, male gender and openended catheter use were signifi cant risk factors reducing survival of TIVADs as determined by univariate and multivariate analyses. Hematogenous malignancy decreased the survival time of TIVADs; this reduction was not statistically signifi cant by univariate analysis [hazard ratio (HR) = 1.336, 95% CI: 0.966-1.849, P = 0.080)]. However, it became a signifi cant risk factor by multivariate analysis (HR = 1.499, 95% CI: 1.079-2.083, P = 0.016) when correlated with variables of age, sex and catheter type. Close-ended (Groshong) catheters had a lower thrombosis rate than open-ended catheters (2.5% vs 5%, P = 0.015). Hematogenous malignancy had higher infection rates than solid malignancy (10.5% vs 2.5%, P < 0.001). CONCLUSION: Increasing age, male gender, openended catheters and hematogenous malignancy were risk factors for TIVAD failure. Close-ended catheters had lower thrombosis rates and hematogenous malignancy had higher infection rates.

Health-promoting behavior is positively associated with diabetic control among type 2 diabetes patients

Background: The increasing prevalence of type 2 diabetes mellitus (T2DM) poses a major public health challenge throughout the world. It is a major healthcare issue among the elderly. This study was to identify the association between the health promoting behaviors and the diabetic control of type 2 diabetes mellitus (T2DM) patients. Methods: Cross sectional and descriptive research designs were used in this study. Participants were enrolled from three medical centers in northern, central and southern Taiwan during August, 2010 and June, 2011. The instruments encompassed biochemical indicators, and the preliminary developed scale of diabetes mellitus and health promotion (DMHP). Results: A total of 323 participants with T2DM were included in this study. The results showed 1) a high percentage of the participants used cigarette smoking, alcohol drinking and betel nut chewing, which were not conducive to adopting health promoting behaviors;2) a high percentage of patients showed abnormal blood glucose, dyslipidemia, and elevated blood pressure;3) few of the participants practiced ideally health promoting behaviors;and 4) practicing health-promoting behavior was positively associated with fasting blood glucose (FBG) and HbA1c levels. Conclusions: Patients with higher health promotion scores had better diabetic control. Less physical activity was found among those addicted to cigarette, alcohol and betel nut consumption. The findings suggest that health care providers should assess health promoting behaviors first for each diabetic patient.