Assessing Cochlear Implant Outcomes in Older Adults Using HERMES: A National Web-based Database

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Abstract

Objective:

Cochlear implant (CI) outcomes research has been largely limited to retrospective or single-institution studies in the United States. The objective is to demonstrate the feasibility of using a novel, national, web-based CI database through evaluating CI outcomes in older adults.

Study Design:

Analysis of a prospective, national, web-based database designed for CI outcome tracking (HERMES; HIPAA-secure, Encrypted, Research Management and Evaluation Solution).

Setting:

Multi-centered at 18 private practice and academic US medical centers.

Patients:

Older (age ≥75, n = 47) or younger (age <75, n = 103) adult CI patients (n = 150 total, n = 160 ears).

Main Outcome Measure(s):

Arizona Biomedical (AzBio), CI usage, postoperative complications.

Results:

Older adults had slightly lower performance on most recent AzBio (56.0%, n = 26, 12.2 ± 6.5 mo postoperatively) compared with younger adults (74.0%, n = 52, 12.6 ± 6.5 mo postoperatively; p < 0.01, Mann–Whitney). However, on multiple regression, age was not a significant predictor of AzBio scores after controlling for sex, hearing loss duration, use, and postoperative follow-up duration. Most recent CI use was similar but significantly different (11.4 h/d in older, n = 24 versus 13.0 in younger, n = 45; p = 0.01). Usage also did not decline over time (p = 0.81 in older versus p = 0.46, in younger). The most common complications were similar (vertigo 25 versus 20%, p = 0.45; tinnitus 4 versus 4%, p = 0.93) in older and younger adults, respectively.

Conclusion:

We demonstrate the feasibility of a novel user-friendly, web-based, national CI database to analyze CI outcomes. Older age was not a significant predictor of AzBio scores after adjusting for multiple factors. Additionally, CI use did not decline over time.

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