Depression and cholesteatoma: Preliminary findings from a nationwide population-based retrospective cohort study

Kuo, Chin Lung; Chang, Nancy Hsaoyen; Shiao, An Suey; Lien, Chiang Feng; Huang, Hui-Ling; Lin, Szu Hai; Chang, Wei Pin

doi:10.1016/j.jad.2016.01.023

Cited by 4 publications

(7 citation statements)

References 18 publications

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“…The original identification numbers of beneficiaries were encrypted for privacy, using methods consistent with those applied to other data sets, to ensure that all claims data could be linked for the extraction of additional medically relevant data. Numerous researchers have used the Taiwan NHIRD in studies published in peer-reviewed journals …”

Section: Methodsmentioning

confidence: 99%

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Association Between Middle Ear Cholesteatoma and Chronic Rhinosinusitis

Kuo

Yen

Chang

et al. 2017

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Chronic rhinosinusitis (CRS) can cause an obstruction of the tubal orifice and thereby compromise ventilation of the middle ear. The resulting negative pressure in the middle ear may, in turn, lead to the formation of an eardrum retraction pocket and subsequent acquired cholesteatoma. This study hypothesizes that CRS may increase the risk of cholesteatoma. OBJECTIVE To evaluate the risk of cholesteatoma in patients with CRS. DESIGN, SETTING, AND PARTICIPANTS This study used a nationwide, population-based claims database to test the hypothesis that CRS may increase the risk of cholesteatoma. The Longitudinal Health Insurance Database of Taiwan was used to compile data from (1) 12 670 patients with newly diagnosed CRS between January 1, 1997, and December 31, 2002, and (2) a comparison cohort of 63 350 matched individuals without CRS, resulting in a CRS vs control ratio of 1:5. Data analysis was performed from June 1 to October 27, 2015. Each patient was followed up for 8 years to identify those in whom cholesteatoma subsequently developed. The Kaplan-Meier method was used to determine the cholesteatoma-free survival rate, and the log-rank test was used to compare survival curves. Cox proportional hazards regression models were used to compute the 8-year hazard ratios (HRs). MAIN OUTCOMES AND MEASURES Diagnosis of cholesteatoma. RESULTS Among the 76 020 patients enrolled in this study, 35 220 (46.3%) were female; mean (SD) age was 27.57 (22.03) years. A total of 209 patients developed cholesteatoma, 66 (101 084 person-years) individuals from the CRS cohort and 143 (506 540 person-years) from the comparison cohort were diagnosed with cholesteatoma during the 8-year follow-up period. The incidence of cholesteatoma per 1000 person-years was more than twice as high among patients with CRS (0.65; 95% CI, 0.50-0.81 person-years) than among those without CRS (0.28; 95% CI, 0.24-0.33). The absolute difference in the incidence density between CRS and non-CRS group was 0.37 (95% CI, 0.21-0.53) per 1000 patient-years. After adjusting for potential confounders, patients with CRS had a 69% increased risk of cholesteatoma within 8 years, compared with those without CRS (HR, 1.69; 95% CI, 1.23-2.32). Patients with CRS presented a significantly lower 8-year cholesteatoma-free survival rate than did those in the comparison group. The absolute difference in the 8-year cholesteatoma-free survival rate between the CRS and non-CRS groups was 0.0029 (95% CI, 0.0016-0.0043). CONCLUSIONS AND RELEVANCE This is the first large-scale study, to date, to demonstrate a prospective link between CRS and the subsequent development of cholesteatoma within a follow-up period of 8 years. The purpose of the study was to draw attention to the possibility of development of cholesteatoma among patients with CRS. Because that possibility exists, clinicians should keep this association in mind as well as the importance of a thorough head and neck examination.

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Section: Methodsmentioning

confidence: 99%

“…Numerous researchers have used the Taiwan NHIRD in studies published in peer-reviewed journals. 16,[19][20][21][22]…”

Section: Databasementioning

confidence: 99%

Association Between Middle Ear Cholesteatoma and Chronic Rhinosinusitis

Kuo

Yen

Chang

et al. 2017

JAMA Otolaryngol Head Neck Surg

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“…Both independent researchers and the Taiwan National Health Research Institute have demonstrated the representative validity of data obtained from the NHI program . Several studies that used LHID2005 data have been published in peer‐reviewed journals …”

Section: Methodsmentioning

confidence: 99%

“…These 1 million beneficiaries represent a random sample of all enrollees listed in the 2005 Registry of Beneficiaries for the NHI program (n = 25.68 million). The LHID2005 covers the period from 1996 to 2010, and includes original NHI medical claims associated with the ambulatory and inpatient care . There are no statistically significant differences in the distributions of gender, age, or healthcare costs between patients in the LHID2005 and the original NHIRD .…”

Section: Methodsmentioning

confidence: 99%

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Increased risk of cholesteatoma among patients with allergic rhinitis: A nationwide investigation

Kuo

Shiao

Wen³

et al. 2017

The Laryngoscope

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Risk of sudden sensorineural hearing loss in stroke patients

et al. 2016

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Poststroke sudden sensorineural hearing loss (SSNHL) can hinder communication between patients and healthcare professionals, thereby restricting participation in rehabilitation programs and limiting improvements in physical performance. However, the relationship between stroke and SSNHL remains unclear. This study employed a nationwide population-based dataset to investigate the relationship between stroke and SSNHL.The Taiwan Longitudinal Health Insurance Database was used to compile data from 11,115 stroke patients and a comparison cohort of 33,345 matched nonstroke enrollees. Each patient was followed for 5 years to identify new-onset SSNHL. Stratified Cox proportional-hazard regression analysis was used to examine the association of stroke with subsequent SSNHL.Among the 44,460 patients, 66 patients (55,378 person-years) from the stroke cohort and 105 patients (166,586 person-years) from the comparison cohort were diagnosed with SSNHL. The incidence of SSNHL was approximately twice as high among stroke patients than among nonstroke patients (1.19 and 0.63/1000 person-years, respectively). Stroke patients had a 71% increased risk of SSNHL, compared with nonstroke patients (adjusted hazard ratio [HR] 1.71, 95% confidence interval [CI] 1.24–2.36). We also observed a remarkable increase in risk of SSNHL in stroke patients within 1-year of follow-up (adjusted HR 5.65, 95% CI 3.07–10.41) or under steroid therapy during hospitalization (adjusted HR 5.14, 95% CI 2.08–12.75).Patients with stroke had a higher risk of subsequent SSNHL compared with patients without stroke. In particular, stroke patients within 1-year follow-up and those undergoing steroid therapy during hospitalization should be treated with the utmost caution, considering that the risk of SSNHL increases by more than 5-fold.

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Depression and cholesteatoma: Preliminary findings from a nationwide population-based retrospective cohort study

Cited by 4 publications

References 18 publications

Association Between Middle Ear Cholesteatoma and Chronic Rhinosinusitis

Association Between Middle Ear Cholesteatoma and Chronic Rhinosinusitis

Increased risk of cholesteatoma among patients with allergic rhinitis: A nationwide investigation

Risk of sudden sensorineural hearing loss in stroke patients

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