Kuo Chin-Lung, Shiao An-Suey, Wang Shuu-Jiun, Chang Wei-Pin, Lin Yung-Yang
Institute of Brain Science, National Yang-Ming University Department of Neurology, Neurological Institute, Taipei Veterans General Hospital Laboratory of Neurophysiology Integrated Brain Research Laboratory, Taipei Veterans General Hospital Faculty of Medicine, National Yang-Ming University School of Medicine Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital School of Health Care Administration, Taipei Medical University Institute of Physiology, National Yang-Ming University Institute of Clinical Medicine, National Yang-Ming University, Taipei Department of Otolaryngology, Taoyuan Armed Forces General Hospital, Taoyuan Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
Medicine (Baltimore). 2016 Sep;95(36):e4841. doi: 10.1097/MD.0000000000004841.
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.
中风后突发性感音神经性听力损失（SSNHL）会妨碍患者与医护人员之间的沟通，从而限制患者参与康复计划，并阻碍身体机能的改善。然而，中风与SSNHL之间的关系仍不明确。本研究采用全国性的基于人群的数据集来调查中风与SSNHL之间的关系。利用台湾纵向健康保险数据库收集了11115名中风患者以及33345名匹配的非中风参保者组成的对照队列的数据。对每位患者进行了5年的随访，以确定新发的SSNHL。采用分层Cox比例风险回归分析来检验中风与后续SSNHL之间的关联。
在这44460名患者中，中风队列中有66名患者（55378人年），对照队列中有105名患者（166586人年）被诊断为SSNHL。中风患者中SSNHL的发病率约为非中风患者的两倍（分别为1.19和0.63/1000人年）。与非中风患者相比，中风患者发生SSNHL的风险增加了71%（调整后的风险比[HR]为1.71，95%置信区间[CI]为1.24 - 2.36）。我们还观察到，在随访1年内中风患者发生SSNHL的风险显著增加（调整后的HR为5.65，95%CI为3.07 - 10.41），或者住院期间接受类固醇治疗的患者也是如此（调整后的HR为5.14，95%CI为2.08 - 12.75）。
与没有中风的患者相比，中风患者发生后续SSNHL的风险更高。特别是，随访1年内的中风患者以及住院期间接受类固醇治疗的患者应格外谨慎对待，因为发生SSNHL的风险增加了5倍多。
