Investigating the Risk of Head and Neck Cancer or Stomach Cancer for Patients with Long-term Tube Placement by Using National Health Insurance Research Database

• Main Authors: Su-Ming Hsiao, 蕭夙茗
• Other Authors: Kuang-Ming Kuo
• Format: Others
• Language: zh-TW
• Published: 2019
• Online Access: http://ndltd.ncl.edu.tw/handle/663rg2

碩士 === 義守大學 === 醫務管理學系 === 107 === Objective: With the increasing ageing and disability populations, the number of patients with long-term tube placement is rising. However, long-term tube placement may cause inflammation, ulcers, gastroesophageal reflux or aspiration pneumonia. Such problems are suspected to relate with the onset of cancer, or even relate with cancer cells metastasizing to other sites via blood or lymph, but the relevant literature is still limited. This study used the national health insurance research database (NHIRD) of Taiwan to investigate the hazard ratio of head/neck cancer or stomach cancer between patients with and without long-term tube placement. Methods: This study was a retrospective cohort study. Data from 1997 to 2013 were used to analyze and compare the hazard ratio of patients with and without long-term tube placement for head/neck cancer or stomach cancer. Confounding factors such as gender, birth year and main diagnosis were controlled by propensity score matching, and the control group was selected at a ratio of 1:2, 1:3 and 1:4. The samples were further divided into head/neck cancer or stomach cancer for more than two years and more than one year. Statistical analysis including Kaplan–Meier survival curves, log-rank test, correlation test, and Cox proportional hazard model were performed. Results: No data was found for long-term gastrostomy tube placement after screening. No matter how long nasogastric tube had been placed and in what sampling ratio, the results demonstrated a significant difference between patients with and without long-term nasogastric tube placement (p < .05), with a hazard ratio of more than 4 times in terms of the onset of head/neck cancer or stomach cancer. Conclusion: Patients with long-term nasogastric tube placement may have a higher risk of head/neck cancer or stomach cancer than those without tube placement. Tube placement conditions should therefore be carefully evaluated and clearly defined to reduce the chance of long-term nasogastric tube placement.