The Effect of Comorbidities on Cochlear Implantation Outcomes in Adults Under 60.

IF 1.6 4区 医学 Q2 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY
Jamie A Schlacter, Christine Schremp, Allen Khudaverdyan, Emily R Spitzer, Susan B Waltzman
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引用次数: 0

Abstract

Introduction: Prior studies have demonstrated that comorbid conditions can negatively impact cochlear implantation (CI) outcomes in elderly patients, but few have examined how comorbidities affect younger adult CI recipients. This study examines the relationship between comorbidities and CI outcomes in adults under 60 years old.

Methods: We reviewed all CI recipients between 20 to 60 years old from 2015-2019 at a tertiary academic medical center. Patient data were collected including comorbidities, demographics, etiology, and length of deafness (LOD). Patients' Charlson Comorbidity Index (CCI) was calculated. The primary outcome was speech perception scores at 1-year on the consonant-nucleus-consonant (CNC) word test.

Results: There were 118 patients who underwent CI (15% 20-29 years, 22% 30-39, 21% 40-49, 42% 50-60), averaging 1.8 comorbidities. Mean LOD was 19.7 years, and most etiologies were unknown (53.4%). 34% had no comorbidities, and the most frequent comorbidities were hypertension (14%), asthma (10%), anxiety (8%), acoustic neuroma (8%), and arthritis (7%). Comorbidity frequency was similar across ages, but cardiovascular comorbidities varied by patient decade (50-60 yrs: 41% vs. 20-49 yrs: 12-22%, p = 0.004). Compared to studies on elderly CI outcomes, our cohort had fewer comorbidities with reduced cardiac events and neurological conditions. We did not find differences in 1-year CNC scores or complications based on the number of comorbidities or any single comorbidity. However, there was a difference in individual improvement in CNC word scores by age group (p = 0.024). Patients' CCI did not correlate to post-op scores.

Conclusion: Subjects showed improved speech understanding post-CI. The number and type of comorbidities were not meaningful predictors of 1-year speech perception scores, suggesting adult CI users under 60 years with comorbidities can expect comparable outcomes to those without comorbidities.

合并症对60岁以下成人人工耳蜗植入结果的影响。
先前的研究表明,合并症会对老年患者的人工耳蜗植入(CI)结果产生负面影响,但很少有人研究合并症对年轻成年人工耳蜗植入接受者的影响。本研究探讨了60岁以下成人的合并症与CI结果之间的关系。方法:我们回顾了一家三级学术医疗中心2015-2019年所有年龄在20 - 60岁之间的CI接受者。收集患者资料,包括合并症、人口统计学、病因学和耳聋时间(LOD)。计算患者Charlson共病指数(CCI)。主要结果是1岁时辅音-核-辅音(CNC)单词测试的语音感知得分。结果:118例患者行CI(20-29岁15%,30-39岁22%,40-49岁21%,50-60岁42%),平均1.8例合并症。平均寿命为19.7年,病因不明占53.4%。34%的患者无合并症,最常见的合并症是高血压(14%)、哮喘(10%)、焦虑(8%)、听神经瘤(8%)和关节炎(7%)。合并症的频率在不同年龄段相似,但心血管合并症因患者年龄而异(50-60岁:41% vs. 20-49岁:12-22%,p = 0.004)。与老年CI结果的研究相比,我们的队列中心脏事件和神经系统疾病减少的合并症较少。我们没有发现基于合并症数量或任何单一合并症的1年CNC评分或并发症的差异。然而,不同年龄组的CNC单词得分在个体改善方面存在差异(p = 0.024)。患者的CCI与术后评分无关。结论:ci后,受试者的言语理解能力有所提高。合并症的数量和类型并不是1年语音感知评分的有意义的预测因素,这表明60岁以下有合并症的成人CI使用者可以预期与无合并症的结果相当。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Audiology and Neuro-Otology
Audiology and Neuro-Otology 医学-耳鼻喉科学
CiteScore
3.20
自引率
6.20%
发文量
35
审稿时长
>12 weeks
期刊介绍: ''Audiology and Neurotology'' provides a forum for the publication of the most-advanced and rigorous scientific research related to the basic science and clinical aspects of the auditory and vestibular system and diseases of the ear. This journal seeks submission of cutting edge research opening up new and innovative fields of study that may improve our understanding and treatment of patients with disorders of the auditory and vestibular systems, their central connections and their perception in the central nervous system. In addition to original papers the journal also offers invited review articles on current topics written by leading experts in the field. The journal is of primary importance for all scientists and practitioners interested in audiology, otology and neurotology, auditory neurosciences and related disciplines.
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