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恶性外耳道炎与糖尿病相关:一项基于人群的病例对照研究。

Malignant Otitis Externa is Associated with Diabetes: A Population-Based Case-Control Study.

作者信息

Yang Tzong-Hann, Xirasagar Sudha, Cheng Yen-Fu, Wu Chuan-Song, Kao Yi-Wei, Shia Ben-Chang, Lin Herng-Ching

机构信息

Department of Otorhinolaryngology, Taipei City Hospital, Taipei.

Department of Speech, Language and Audiology, National Taipei University of Nursing and Health.

出版信息

Ann Otol Rhinol Laryngol. 2020 Jun;129(6):585-590. doi: 10.1177/0003489419901139. Epub 2020 Jan 24.

Abstract

OBJECTIVE

Despite studies reporting a possible association between malignant otitis externa (MOE) and diabetes, there are no large-scale population-based empirical studies. This nationwide, population-based case-control study explored the association of MOE occurrence with previously diagnosed diabetes.

METHODS

Data were retrieved from Taiwan's National Health Insurance Research Database, 753 patients with MOE (cases) and 2 259 propensity score-matched patients without MOE (controls). Multiple logistic regressions were conducted to examine the association of MOE with previously diagnosed diabetes.

RESULTS

In total, 728 (24.2%) out of 3 012 sample patients had diabetes prior to the index date. Chi-square test revealed a significant difference in diabetes prevalence among cases and controls (54.8% vs 13.9%,  < 0.001). Simple logistic regression showed the odds ratio for prior diabetes among cases versus controls was 7.50 (95% CI, 6.229.03). The adjusted odds ratio of prior diabetes for cases versus controls was 10.07 (95% CI, 8.1512.44) after adjusting for patient demographics and medical co-morbidities.

CONCLUSIONS

This study found an association between MOE and diabetes. One clinical practice implication of our study is that when a patient with diabetes complains of otalgia or otorrhea, and physical examination shows swelling of the ear canal or granulation growth, physicians should consider the possibility of MOE.

摘要

目的

尽管有研究报告恶性外耳道炎(MOE)与糖尿病之间可能存在关联,但尚无基于大规模人群的实证研究。这项全国性的基于人群的病例对照研究探讨了MOE发生与先前诊断的糖尿病之间的关联。

方法

数据取自台湾国民健康保险研究数据库,753例MOE患者(病例组)和2259例倾向评分匹配的非MOE患者(对照组)。进行多因素逻辑回归分析以检验MOE与先前诊断的糖尿病之间的关联。

结果

在3012例样本患者中,共有728例(24.2%)在索引日期之前患有糖尿病。卡方检验显示病例组和对照组的糖尿病患病率存在显著差异(54.8%对13.9%,P<0.001)。单因素逻辑回归显示,病例组与对照组相比,先前患糖尿病的优势比为7.50(95%CI,6.229.03)。在调整患者人口统计学和合并症后,病例组与对照组相比,先前患糖尿病的调整优势比为10.07(95%CI,8.1512.44)。

结论

本研究发现MOE与糖尿病之间存在关联。我们研究的一个临床实践意义是,当糖尿病患者主诉耳痛或耳漏,且体格检查显示耳道肿胀或有肉芽生长时,医生应考虑MOE的可能性。

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