Increased Risk of Injury in Ménière's Disease and Effects of Treatment: Population-Based Retrospective Cohort Study.

ABSTRACT

OBJECTIVE: To investigate the risk of injury in patients with Ménière's disease (MD) and the effects of treatment. STUDY DESIGN: Population-based retrospective cohort study. SETTING: Data were collected from the Longitudinal Health Insurance Database 2005, containing the information of 2 million randomly selected individuals in Taiwan. METHODS: We enrolled 90,481 patients with newly diagnosed MD between 2000 and 2017 and 361,924 matched individuals without MD. The study outcomes were diagnoses of all-cause injuries. The Kaplan-Meier method was used to determine the cumulative incidence rates of injury in the MD and non-MD cohorts, and a log-rank test was used to analyze the differences between the cohorts. Cox proportional hazards models were used to calculate the 18-year hazard ratios of each cohort. RESULTS: A total of 80,151 patients were diagnosed with injuries during the follow-up period 24,031 and 56,120 from the MD and non-MD cohorts, respectively. The adjusted hazard ratio (aHR) was 2.19 (95% CI, 2.16-2.35) after adjusting for demographic characteristics and comorbidities. Subgroup analysis revealed that MD was associated with an increased incidence of unintentional and intentional injuries (aHR, 2.24 [95% CI, 2.21-2.41] and 2.05 [95% CI, 2.01-2.19], respectively). Treatment with diuretics, antivertigo medications, or surgery did not reduce the risk of injury (aHR, 0.98 [95% CI, 0.59-1.54], 0.94 [95% CI, 0.58-1.50], and 0.99 [95% CI, 0.61-1.54]). CONCLUSION: MD is independently associated with an increased risk of injuries. Medical or surgical treatment for MD does not reduce the risk of injury in patients with MD. Physicians should counsel patients with MD regarding preventive measures for avoiding subsequent injuries.