Individual Patient Comorbidities and Effect on Cochlear Implant Performance.
Otol Neurotol
; 45(4): e281-e288, 2024 Apr 01.
Article
em En
| MEDLINE
| ID: mdl-38437816
ABSTRACT
OBJECTIVE:
To examine the association between preoperative comorbidities and cochlear implant speech outcomes. STUDYDESIGN:
Retrospective cohort.SETTING:
Tertiary referral center. PATIENTS A total of 976 patients who underwent cochlear implantation (CI) between January 2015 and May 2022. Adult patients with follow-up, preoperative audiologic data, and a standardized anesthesia preoperative note were included. EXPOSURE Adult Comorbidity Evaluation 27 (ACE-27) based on standardized anesthesia preoperative notes. MAIN OUTCOMEMEASURES:
Postoperative change in consonant-nucleus-consonant (CNC) score, AzBio Sentence score in quiet, and AzBio + 10 dB signal-to-noise ratio (SNR). Sentence score of the implanted ear at 3, 6, and 12 months.RESULTS:
A total of 560 patients met inclusion criteria; 112 patients (20%) had no comorbidity, 204 patients (36.4%) had mild comorbidities, 161 patients (28.8%) had moderate comorbidities, and 83 patients (14.8%) had severe comorbidities. Mixed model analysis revealed all comorbidity groups achieved a clinically meaningful improvement in all speech outcome measures over time. This improvement was significantly different between comorbidity groups over time for AzBio Quiet ( p = 0.045) and AzBio + 10 dB SNR ( p = 0.0096). Patients with severe comorbidities had worse outcomes. From preop to 12 months, the estimated marginal mean difference values (95% confidence interval) between the no comorbidity group and the severe comorbidity group were 52.3 (45.7-58.9) and 32.5 (24.6-40.5), respectively, for AzBio Quiet; 39.5 (33.8-45.2) and 21.2 (13.6-28.7), respectively, for AzBio + 10 dB SNR; and 43.9 (38.7-49.0) and 31.1 (24.8-37.4), respectively, for CNC.CONCLUSIONS:
Comorbidities as assessed by ACE-27 are associated with CI performance. Patients with more severe comorbidities have clinically meaningful improvement but have worse outcome compared to patients with no comorbidities.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Percepção da Fala
/
Implantes Cocleares
/
Implante Coclear
Limite:
Adult
/
Humans
Idioma:
En
Revista:
Otol Neurotol
Assunto da revista:
NEUROLOGIA
/
OTORRINOLARINGOLOGIA
Ano de publicação:
2024
Tipo de documento:
Article