Inpatient treatment of patients with idiopathic sudden sensorineural hearing loss: a population-based healthcare research study

Heuschkel, A; Geißler, Katharina; Boeger, Daniel; Buentzel, Jens; Eßer, Dirk; Hoffmann, K.; Jecker, Peter; Mueller, Andréas; Radtke, Gerald; Guntinas‐Lichius, Orlando

doi:10.1007/s00405-018-4870-2

Cited by 7 publications

(11 citation statements)

References 19 publications

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“…There are only eight hospitals with departments of otolaryngology. The departments of otolaryngology have built a network primarily to improve health services research in the field of otolaryngology (for instance, [10–13]). Use of this network provided an ideal platform for a population-based analysis of the 30-day readmission rates of unselected otolaryngology inpatients treated in 2015 in Thuringia in daily practice with focus on unplanned readmissions and its predictors.…”

Section: Introductionmentioning

confidence: 99%

30-day unplanned readmission rate in otolaryngology patients: A population-based study in Thuringia, Germany

et al. 2019

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PurposeAnalyze associations between patients’ characteristics and treatment factors with 30-day unplanned readmissions in hospitalized otolaryngology patients in the German Diagnosis Related Group (D-DRG) system.MethodsA retrospective cohort study was performed on 15.271 otolaryngology admissions of 12.859 patients in 2015 in Thuringia, Germany. The medical records of the 1173 cases (7.6%) with readmission within 30-days were analyzed in detail.ResultsThe 30-day readmission was planned in 747 cases (4.9%) and was unplanned in 422 cases (2.8%). The median interval between primary and next inpatient treatment was 11 days. The principal diagnosis was the same as during the primary index treatment in 72% of the cases. The most frequent reasons for readmission were: Need for non-surgical therapy (31.2%), need for further surgery (26.3%), post-surgical complaints (16.9%), and recurrence of primary complaints (10.7%). The multivariate analysis revealed that discharge due to patient’s request against medical advice was a strong independent factor with high risk for unplanned readmission (Odds Ratio [OR] = 9.62]; confidence interval [CI] = 2.69–34.48). Surgery at index admission (OR = 3.33; CI = 1.86–5.96) was the second important independent risk factor for unplanned readmission. Unplanned readmission had more frequently a non-surgical treatment at readmission than a surgical treatment (OR = 3.92; CI = 2.24–6.84) and needed more frequently further diagnostics (OR = 2.34; CI = 1.34–4.11). The following index International Classification of Diseases (ICD) categories had the highest risk for unplanned readmission: Injury, poisoning and certain other consequences of external causes, ICD: S00-T98 (OR = 66.67; CI = 15.87–333.33), symptoms, signs, abnormal findings, ill-defined causes, not otherwise classified, ICD: R00-R99 (OR = 62.5; CI = 11.76–333.33), blood forming organ diseases, ICD: D50-D90 (OR = 21.276; CI = 3.508–125), and eye/ ear diseases, ICD: H00-H95 (OR = 12.66; CI = 4.29–37.03).ConclusionsThe causes of unplanned 30-day readmission in German otolaryngology inpatients are multifactorial. Specific patient and treatment characteristics were identified to be targeted with health care interventions to decrease unplanned readmissions.

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Section: Introductionmentioning

confidence: 99%

30-day unplanned readmission rate in otolaryngology patients: A population-based study in Thuringia, Germany

et al. 2019

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“…This toxin could penetrate in the internal ear through the round window. They lead an irreversible involvement of bone conduction[10].Anne heuschkel reported an ascendancy of the sudden hearing loss among old subject (age median 60 years) in his series of 490 patients[11]. The absence of subsidy for the hearing aid, would explain the important number of young people in our series.…”

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confidence: 75%

Etiologies of the Hearing Loss and Their Impacts at the Patients Worn Hearing Aid in the International Center of Hearing Correction in Abidjan (ICHC)

Ange¹,

Salha²,

Nadine³

et al. 2018

IJOHNS

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Objective: Determine the etiologies and their impacts of hearing loss at the patients' worn hearing aid in the international center of hearing correction in Abidjan (ICHC). Material and Method: The study is of transverse and analytical type realized in the ICHC from July 1999 to June 2010. It concerned the files of patients' worn hearing aid in the center. The patients worn initially in another center but followed in the ICHC were excluded. Data were collected from medical files of patients and concerned etiologies, age, type, degree of hearing loss as well as the prosthetic gains and the satisfaction. Results: Fifteen etiologies were listed with in first three rows the meningitis (17.9%) the presbyacusis (17.5%) and chronic otitis media (12.1%). The degrees of hearing loss in the seven etiologies most frequent were severe and profound in 87.6% of cases to the right and 82.8% to the left. The prosthetic pure tonal gain was significant in case of sound trauma and sudden hearing loss. The prosthetic speech reception threshold gain was only significant in case of presbyacusis and sudden hearing loss. The satisfaction of hearing aids was significant in case of presbyacusis, sudden hearing loss and the sound trauma. Conclusion: The main clauses etiologies were the meningitis and the presbyacusis. The tonal and speech prosthetic gain were significant in case of sudden hearing loss.

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“…The extent of the initial hearing loss was described using the pure-tone average (PTA) in decibels hearing level (dB HL). The average hearing loss of the three most affected frequencies (3PTAmax), 10 frequencies (10PTA: 0.125; 0.25; 0.5; 1; 1.5; 2; 3; 4; 6; 8 kHz), 9 frequencies (9PTA: 0.125; 0.25; 0.5; 1; 2; 3; 4; 6; 8 kHz), 4frequencies (4PTA: 0.5; 1; 2; 4 kHz), low- (LF3PTA: 0.125; 0.5; 1 kHz), middle- (MF3PTA: 2; 3; 4 kHz), and high frequency (HF2PTA: 6; 8 kHz) hearing loss were calculated [ 3 , 13 , 14 ]. Hearing losses that were not technically measurable and deafness were considered as hearing loss of 120 dB.…”

Section: Methodsmentioning

confidence: 99%

“…So far, many studies have analyzed epidemiological data for idiopathic sudden sensorineural hearing loss (ISSNHL) [ 1 , 2 ]. In a previous study on the ISSNHL, left side, non-declining audiogram type and no previous outpatient treatment as independent prognostic factors for a better recovery could be found [ 3 ]. Profound hearing loss, hearing loss in older patients, delayed treatment and arterial hypertension were negative prognostic factors in another study [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…These have formed a network for the scientific evaluation of ENT diseases [ 11 , 12 ]. Recently, we have published data on all patients who were hospitalized in Thuringia in 2011 and 2012 for treatment of ISSNHL [ 3 , 11 , 12 ]. Here, we compare now the results of these patients with ISSNHL to the patients treated for NISSNHL in the same time period.…”

Section: Introductionmentioning

confidence: 99%

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Patients with non-idiopathic sudden sensorineural hearing loss show hearing improvement more often than patients with idiopathic sudden sensorineural hearing loss

Thielker

Heuschkel

Boeger

et al. 2021

Eur Arch Otorhinolaryngol

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Introduction To compare inpatient treated patients with idiopathic (ISSNHL) and non-idiopathic sudden sensorineural hearing loss (NISSNHL) regarding frequency, hearing loss, treatment and outcome. Methods All 574 inpatient patients (51% male, median age: 60 years) with ISSNHL and NISSNHL, who were treated in federal state Thuringia in 2011 and 2012, were included retrospectively. Univariate and multivariate statistical analyses were performed. Results ISSNHL was diagnosed in 490 patients (85%), NISSNHL in 84 patients (15%). 49% of these cases had hearing loss due to acute otitis media, 37% through varicella-zoster infection or Lyme disease, 10% through Menière disease and 7% due to other reasons. Patients with ISSNHL and NISSNHL showed no difference between age, gender, side of hearing loss, presence of tinnitus or vertigo and their comorbidities. 45% of patients with ISSNHL and 62% with NISSNHL had an outpatient treatment prior to inpatient treatment (p < 0.001). The mean interval between onset of hearing loss to inpatient treatment was shorter in ISSNHL (7.7 days) than in NISSNHL (8.9 days; p = 0.02). The initial hearing loss of the three most affected frequencies in pure-tone average (3PTAmax) scaled 72.9 dBHL ± 31.3 dBHL in ISSNHL and 67.4 dBHL ± 30.5 dBHL in NISSNHL. In the case of acute otitis media, 3PTAmax (59.7 dBHL ± 24.6 dBHL) was lower than in the case of varicella-zoster infection or Lyme disease (80.11 dBHL ± 34.19 dBHL; p = 0.015). Mean absolute hearing gain (Δ3PTAmaxabs) was 8.1 dB ± 18.8 dB in patients with ISSNHL, and not different in NISSNHL patients with 10.2 dB ± 17.6 dB. A Δ3PTAmaxabs ≥ 10 dB was reached in 34.3% of the patients with ISSNHL and to a significantly higher rate of 48.8% in NISSNHL patients (p = 0.011). Conclusions ISSNHL and NISSNHL show no relevant baseline differences. ISSNHL tends to have a higher initial hearing loss. NISSHNL shows a better outcome than ISSNHL.

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Inpatient treatment of patients with idiopathic sudden sensorineural hearing loss: a population-based healthcare research study

Abstract: Inpatient treatment of ISSNHL is variable in daily practice. The population-based recovery rate was worse than reported in clinical trials. More standardization and clearer criteria for outpatient, inpatient, and salvage therapy are needed.

Cited by 7 publications

References 19 publications

30-day unplanned readmission rate in otolaryngology patients: A population-based study in Thuringia, Germany

30-day unplanned readmission rate in otolaryngology patients: A population-based study in Thuringia, Germany

Etiologies of the Hearing Loss and Their Impacts at the Patients Worn Hearing Aid in the International Center of Hearing Correction in Abidjan (ICHC)

Patients with non-idiopathic sudden sensorineural hearing loss show hearing improvement more often than patients with idiopathic sudden sensorineural hearing loss

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