Impact of Implantable Hearing Devices on Delirium Risk in Patients with Hearing Loss: A National Database Study.

Objective: Exploring whether the utilization of implantable hearing rehabilitation devices is associated with a reduced likelihood of developing delirium in patients with hearing loss.

Study design: A retrospective cohort database study with propensity score matching (PSM) utilizing TriNetX clinical database.

Setting: The US Collaborative Network within the TriNetX database (100 million people).

Patients: Patients over 55 years old were selected based on three categories: a non-hearing loss study control (ICD-10: H90-91), a hearing loss (HL without implantable device), and an implantable device cohort (ICD-10: Z96.21, Z96.29, 09HD, 09HE; CPT: 69714, 69930). Patients with prior dementia or memory loss diagnosis were excluded (F01-03, 27-29).

Interventions: Observational.

Main outcome measures: Odds ratios with 95% confidence intervals for delirium diagnosis code (F0.5).

Results: The control cohort (n = 36.5 million) was 1:1 PSM for age and sex with the HL cohort (n = 1.77 million) in which 0.28% of patients developed delirium compared to 0.74% in the HL cohort (OR 2.66, 95% CI = 2.58-2.75). When looking at the same PSM between HL and implantable device cohorts (n = 20,847), 0.81% developed a delirium diagnosis compared to 0.45% in the implantable device cohort (OR = 1.79, 95% CI = 1.39-2.31). Further analysis accounting for 16 PSM covariates showed that 0.74% of the HL cohort developed delirium compared to 0.45% of the implantable device cohort (OR = 1.64, 95% CI = 1.27-2.13).

Conclusions: The present study shows that patients with hearing loss were more likely to develop delirium than those with normal hearing. Importantly, patients with implantable hearing devices were significantly less likely to develop delirium compared to hearing loss patients without an implantable device. Our research highlights the importance of treating hearing loss to prevent delirium.Level of Evidence: III.