{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T15:04:12Z","timestamp":1777043052904,"version":"3.51.4"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dysphagia in older adults often necessitates long term parenteral nutrition (TPN). However, the optimal central venous access strategy, including implantable central venous access port (ICVAP), non-tunneled central venous catheter (NT-CVC) or peripherally inserted central catheter (PICC), remains uncertain, particularly regarding survival and complication risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 73 patients aged \u226565\u202fyears with dysphagia who received parenteral nutrition via ICVAP, NT-CVC, or PICC. Device selection was based on patient\/family request and feasibility\/acceptability at the discharge destination. Baseline characteristics were compared using ANOVA and chi-square\/Fisher\u2019s exact tests, and standardized mean differences (SMD) were reported to quantify baseline imbalance. Survival was evaluated using Kaplan\u2013Meier curves with log-rank tests. Multivariable Cox proportional hazards models were performed to adjust for predefined covariates. Short-term mortality and complications were compared using chi-square or Fisher\u2019s exact tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Survival differed significantly among the three groups (log-rank\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), with median survival of 305\u202fdays for ICVAP, 195\u202fdays for PICC, and 43\u202fdays for NT-CVC. After adjustment, NT-CVC was associated with a significantly higher mortality risk compared to ICVAP (HR\u202f=\u202f4.15, 95% CI: 1.17\u201314.78,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.028), while no significant difference was observed between PICC and ICVAP (HR\u202f=\u202f1.05, 95% CI: 0.36\u20133.04,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.927). Independent predictors of mortality included advanced age (HR\u202f=\u202f1.08,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.004), lower BMI (HR\u202f=\u202f0.89,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.034), higher CFS (HR\u202f=\u202f3.70,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.027), and total lymphocyte count (TLC) (HR\u202f=\u202f1.00,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.009). NT-CVC had the highest short-term mortality (34.6% at 30\u202fdays, 73.1% at 90\u202fdays,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). No significant differences were observed in pneumonia or sepsis rates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this cohort of elderly patients with dysphagia receiving long-term parenteral nutrition, ICVAP use was associated with longer survival compared with NT-CVC, while no significant survival difference was observed between PICC and ICVAP. Given the retrospective design and non-random catheter selection, these findings should be interpreted as associations and warrant confirmation in prospective, multicenter studies incorporating standardized complication definitions and patient-centered outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1765556","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T05:33:17Z","timestamp":1775626397000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparing central venous access strategies in elderly patients with dysphagia: a survival analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Yuetong","family":"Rong","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, Peking University Third Hospital","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao","family":"Liu","sequence":"additional","affiliation":[{"name":"Peking University School of Nursing","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Li","sequence":"additional","affiliation":[{"name":"Peking University School of Nursing","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heli","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Peking University Third Hospital","place":["Beijing, China"]},{"name":"Department of Nursing, Peking University Third Hospital","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guoqing","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Peking University Third Hospital","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baohua","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Nursing, Peking University Third Hospital","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaomei","family":"Shang","sequence":"additional","affiliation":[{"name":"Peking University School of Nursing","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1403","DOI":"10.2147\/CIA.S107750","article-title":"European Society for Swallowing Disorders \u2013 European Union geriatric medicine society white paper: oropharyngeal dysphagia as a geriatric 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