Associations between hearing loss and clinical outcomes: population-based cohort studyResearch in context
Summary: Background: Hearing loss (HL) is a leading cause of disability worldwide, but its clinical consequences and population burden have been incompletely studied. Methods: We did a retrospective population-based cohort study of 4,724,646 adults residing in Alberta between April 1, 2004 and Marc...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-07-01
|
| Series: | EClinicalMedicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537023002456 |
| _version_ | 1797790810808254464 |
|---|---|
| author | Marcello Tonelli Natasha Wiebe Meg Lunney Maoliosa Donald Tanis Howarth Julie Evans Scott W. Klarenbach David Nicholas Tiffany Boulton Stephanie Thompson Kara Schick Makaroff Braden Manns Brenda Hemmelgarn |
| author_facet | Marcello Tonelli Natasha Wiebe Meg Lunney Maoliosa Donald Tanis Howarth Julie Evans Scott W. Klarenbach David Nicholas Tiffany Boulton Stephanie Thompson Kara Schick Makaroff Braden Manns Brenda Hemmelgarn |
| author_sort | Marcello Tonelli |
| collection | DOAJ |
| description | Summary: Background: Hearing loss (HL) is a leading cause of disability worldwide, but its clinical consequences and population burden have been incompletely studied. Methods: We did a retrospective population-based cohort study of 4,724,646 adults residing in Alberta between April 1, 2004 and March 31, 2019, of whom 152,766 (3.2%) had HL identified using administrative health data. We used administrative data to identify comorbidity and clinical outcomes, including death, myocardial infarction, stroke/transient ischemic attack, depression, dementia, placement in long-term care (LTC), hospitalization, emergency visits, pressure ulcers, adverse drug events and falls. We used Weibull survival models (binary outcomes) and negative binomial models (rate outcomes) to compare the likelihood of outcomes in those with vs without HL. We calculated population-attributable fractions to estimate the number of binary outcomes associated with HL. Findings: The age-sex-standardized prevalence of all 31 comorbidities at baseline was higher among participants with HL than those without. Over median follow-up of 14.4 y and after adjustment for potential confounders at baseline, participants with HL had higher rates of days in hospital (rate ratio 1.65, 95% CI 1.39, 1.97), falls (RR 1.72, 95% CI 1.59, 1.86), adverse drug events (RR 1.40, 95% CI 1.35, 1.45), and emergency visits (RR 1.21, 95% CI 1.14, 1.28) compared to those without, and higher adjusted hazards of death, myocardial infarction, stroke/transient ischemic attack, depression, heart failure, dementia, pressure ulcers and LTC placement. The estimated number of people with HL who required new LTC placement annually in Canada was 15,631, of which 1023 were attributable to HL. Corresponding estimates for new dementia among people with HL were 14,959 and 4350, and for stroke/TIA the estimates were 11,582 and 2242. Interpretation: HL is common, is often accompanied by substantial comorbidity, and is associated with significant increases in risk for a broad range of adverse clinical outcomes, some of which are potentially preventable. This high population health burden suggests that increased and coordinated investment is needed to improve the care of people with HL. Funding: Canadian Institutes of Health Research; David Freeze chair in health services research. |
| first_indexed | 2024-03-13T02:09:50Z |
| format | Article |
| id | doaj.art-2976db7ac9f44af1b8af8c7e0a2c5c79 |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-03-13T02:09:50Z |
| publishDate | 2023-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-2976db7ac9f44af1b8af8c7e0a2c5c792023-07-01T04:35:29ZengElsevierEClinicalMedicine2589-53702023-07-0161102068Associations between hearing loss and clinical outcomes: population-based cohort studyResearch in contextMarcello Tonelli0Natasha Wiebe1Meg Lunney2Maoliosa Donald3Tanis Howarth4Julie Evans5Scott W. Klarenbach6David Nicholas7Tiffany Boulton8Stephanie Thompson9Kara Schick Makaroff10Braden Manns11Brenda Hemmelgarn12Department of Medicine, University of Calgary, Calgary, Canada; Corresponding author. University of Calgary, 7th Floor, CWPH Building, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.Department of Medicine, University of Alberta, Edmonton, CanadaDepartment of Medicine, University of Calgary, Calgary, CanadaDepartment of Medicine, University of Calgary, Calgary, CanadaAlberta Health Services, Calgary, CanadaAlberta Health Services, Kitscoty, CanadaDepartment of Medicine, University of Alberta, Edmonton, CanadaFaculty of Social Work, University of Calgary, Calgary, CanadaDepartment of Community Health Sciences, University of Calgary, CanadaDepartment of Medicine, University of Alberta, Edmonton, CanadaFaculty of Nursing, University of Alberta, Edmonton, CanadaDepartment of Medicine, University of Calgary, Calgary, CanadaDepartment of Medicine, University of Alberta, Edmonton, CanadaSummary: Background: Hearing loss (HL) is a leading cause of disability worldwide, but its clinical consequences and population burden have been incompletely studied. Methods: We did a retrospective population-based cohort study of 4,724,646 adults residing in Alberta between April 1, 2004 and March 31, 2019, of whom 152,766 (3.2%) had HL identified using administrative health data. We used administrative data to identify comorbidity and clinical outcomes, including death, myocardial infarction, stroke/transient ischemic attack, depression, dementia, placement in long-term care (LTC), hospitalization, emergency visits, pressure ulcers, adverse drug events and falls. We used Weibull survival models (binary outcomes) and negative binomial models (rate outcomes) to compare the likelihood of outcomes in those with vs without HL. We calculated population-attributable fractions to estimate the number of binary outcomes associated with HL. Findings: The age-sex-standardized prevalence of all 31 comorbidities at baseline was higher among participants with HL than those without. Over median follow-up of 14.4 y and after adjustment for potential confounders at baseline, participants with HL had higher rates of days in hospital (rate ratio 1.65, 95% CI 1.39, 1.97), falls (RR 1.72, 95% CI 1.59, 1.86), adverse drug events (RR 1.40, 95% CI 1.35, 1.45), and emergency visits (RR 1.21, 95% CI 1.14, 1.28) compared to those without, and higher adjusted hazards of death, myocardial infarction, stroke/transient ischemic attack, depression, heart failure, dementia, pressure ulcers and LTC placement. The estimated number of people with HL who required new LTC placement annually in Canada was 15,631, of which 1023 were attributable to HL. Corresponding estimates for new dementia among people with HL were 14,959 and 4350, and for stroke/TIA the estimates were 11,582 and 2242. Interpretation: HL is common, is often accompanied by substantial comorbidity, and is associated with significant increases in risk for a broad range of adverse clinical outcomes, some of which are potentially preventable. This high population health burden suggests that increased and coordinated investment is needed to improve the care of people with HL. Funding: Canadian Institutes of Health Research; David Freeze chair in health services research.http://www.sciencedirect.com/science/article/pii/S2589537023002456Hearing lossEpidemiology |
| spellingShingle | Marcello Tonelli Natasha Wiebe Meg Lunney Maoliosa Donald Tanis Howarth Julie Evans Scott W. Klarenbach David Nicholas Tiffany Boulton Stephanie Thompson Kara Schick Makaroff Braden Manns Brenda Hemmelgarn Associations between hearing loss and clinical outcomes: population-based cohort studyResearch in context EClinicalMedicine Hearing loss Epidemiology |
| title | Associations between hearing loss and clinical outcomes: population-based cohort studyResearch in context |
| title_full | Associations between hearing loss and clinical outcomes: population-based cohort studyResearch in context |
| title_fullStr | Associations between hearing loss and clinical outcomes: population-based cohort studyResearch in context |
| title_full_unstemmed | Associations between hearing loss and clinical outcomes: population-based cohort studyResearch in context |
| title_short | Associations between hearing loss and clinical outcomes: population-based cohort studyResearch in context |
| title_sort | associations between hearing loss and clinical outcomes population based cohort studyresearch in context |
| topic | Hearing loss Epidemiology |
| url | http://www.sciencedirect.com/science/article/pii/S2589537023002456 |
| work_keys_str_mv | AT marcellotonelli associationsbetweenhearinglossandclinicaloutcomespopulationbasedcohortstudyresearchincontext AT natashawiebe associationsbetweenhearinglossandclinicaloutcomespopulationbasedcohortstudyresearchincontext AT meglunney associationsbetweenhearinglossandclinicaloutcomespopulationbasedcohortstudyresearchincontext AT maoliosadonald associationsbetweenhearinglossandclinicaloutcomespopulationbasedcohortstudyresearchincontext AT tanishowarth associationsbetweenhearinglossandclinicaloutcomespopulationbasedcohortstudyresearchincontext AT julieevans associationsbetweenhearinglossandclinicaloutcomespopulationbasedcohortstudyresearchincontext AT scottwklarenbach associationsbetweenhearinglossandclinicaloutcomespopulationbasedcohortstudyresearchincontext AT davidnicholas associationsbetweenhearinglossandclinicaloutcomespopulationbasedcohortstudyresearchincontext AT tiffanyboulton associationsbetweenhearinglossandclinicaloutcomespopulationbasedcohortstudyresearchincontext AT stephaniethompson associationsbetweenhearinglossandclinicaloutcomespopulationbasedcohortstudyresearchincontext AT karaschickmakaroff associationsbetweenhearinglossandclinicaloutcomespopulationbasedcohortstudyresearchincontext AT bradenmanns associationsbetweenhearinglossandclinicaloutcomespopulationbasedcohortstudyresearchincontext AT brendahemmelgarn associationsbetweenhearinglossandclinicaloutcomespopulationbasedcohortstudyresearchincontext |