目标:尽管接受了彻底的人工耳蜗(CI)候选资格评估和咨询,一些患者最终选择反对植入。这项研究旨在确定预测CI延迟的患者相关和社会经济因素。
方法:对2007年至2021年在三级学术CI中心就诊的成人(≥18岁)CI候选人进行了回顾性研究。主要结果是装置植入。收集的数据包括年龄,性别,听力状态,种族,居住的邮政编码,家庭收入中位数(MFI),距离CI中心,婚姻状况,就业状况,和保险状况。进行多变量二元逻辑回归以确定植入的预测因子。
结果:共纳入200名符合CI要求的患者,包括77名推迟手术的成年人(CI-延迟)和123名连续选择手术的成年人(CI-追求)。年龄,性别,听力状态,保险类型,就业状况,与植入物中心的距离,MFI和MFI组间比较(p>0.05)。与追求CI的患者相比,CI延迟患者更有可能是非高加索人(24.7%vs.9.8%,p=0.015)和未婚(55.8%vs.38.2%,p=0.015)。在多变量逻辑回归中,年龄较大(OR0.981,0.964-0.998,p=0.027),非裔美国人种族(OR0.227,0.071-0.726,p=0.012),未婚状态(OR0.505,0.273-0.935,p=0.030)是植入物延期的独立预测因素。
结论:这项研究表明,评估时年龄的增加,非裔美国人种族,和未婚状态是推迟CI手术的预测因素,尽管是植入物候选人。这些患者可能会受益于以咨询形式增加的外展,教育,以及在实施CI手术之前的社会支持。
方法:3-内部对照组喉镜的回顾性研究,2023年。
OBJECTIVE: Despite undergoing thorough cochlear implant (CI) candidacy evaluation and counseling, some patients ultimately elect against implantation. This study sought to identify patient-related and socioeconomic factors predicting CI deferral.
METHODS: A retrospective study of adult (≥18 years old) CI candidates presenting between 2007 and 2021 at a tertiary academic CI center was performed. The primary outcome was device implantation. Data collected included age, gender, hearing status,
race, zip code of residence, median family income (MFI), distance traveled from the CI center, marital status, employment status, and insurance status. Multivariable binary logistic regression was performed to identify predictors of implantation.
RESULTS: A total of 200 patients qualifying for CI were included, encompassing 77 adults deferring surgery (CI-deferred) and 123 consecutive adults electing for surgery (CI-pursued). Age, gender, hearing status, insurance type, employment status, distance from the implant center, and MFI were comparable between the groups (p > 0.05). Compared to CI-pursued patients, CI-deferred patients were more likely to be non-Caucasian (24.7% vs. 9.8%, p = 0.015) and unmarried (55.8% vs. 38.2%, p = 0.015). On multivariable logistic regression, older age (OR 0.981, 0.964-0.998, p = 0.027), African American
race (OR 0.227, 0.071-0.726, p = 0.012), and unmarried status (OR 0.505, 0.273-0.935, p = 0.030) were independent predictors of implant deferral.
CONCLUSIONS: This study demonstrates that increasing age at evaluation, African American
race, and unmarried status are predictors for deferring CI surgery despite being implant candidates. These patients may benefit from increased outreach in the form of counseling, education, and social support prior to undergoing CI surgery.
METHODS: 3 - retrospective study with internal control group Laryngoscope, 134:2857-2863, 2024.