老年美国成年人听力损失严重程度和使用助听器与住院的关系。
Associations of Hearing Loss Severity and Hearing Aid Use With Hospitalization Among Older US Adults.
机构信息
Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.
Department of Surgery, Stanford University, Stanford, California.
出版信息
JAMA Otolaryngol Head Neck Surg. 2022 Nov 1;148(11):1005-1012. doi: 10.1001/jamaoto.2022.2399.
IMPORTANCE
Hearing loss is associated with higher hospitalization risk among older adults. However, evidence on whether hearing aid use is associated with fewer hospitalizations among individuals with hearing loss remains limited.
OBJECTIVE
To assess the association between audiometric hearing loss severity and hearing aid use and hospitalization.
DESIGN, SETTING, AND PARTICIPANTS: This population-based cross-sectional study used audiometric and health care utilization data for respondents aged 65 years or older from 4 cycles of the National Health and Nutrition Examination Survey from 2005 to 2016. Data were analyzed from February 23, 2021, to March 22, 2022.
EXPOSURES
Audiometric hearing loss severity and participant-reported hearing aid use.
MAIN OUTCOMES AND MEASURES
The main outcome was respondent-reported hospitalization in the past 12 months. Multivariable logistic regression was performed to assess the association of hearing loss severity with hospitalization. To assess the association of hearing aid use with hospitalization, propensity score matching was performed with 2:1 nearest neighbor matching without replacement.
RESULTS
Of 2060 respondents (mean [SD] age, 73.9 [5.9] years; 1045 [50.7%] male), 875 (42.5%) had normal hearing, 653 (31.7%) had mild hearing loss, 435 (21.1%) had moderate hearing loss, and 97 (4.7%) had severe to profound hearing loss. On multivariable analysis, moderate and severe hearing loss were associated with hospitalization (moderate hearing loss: odds ratio [OR], 1.50; 95% CI, 1.01-2.24; severe hearing loss: OR, 1.71; 95% CI, 1.03-2.84). Of 1185 respondents with at least mild hearing loss, 200 (16.9%) reported using a hearing aid. Propensity score-matched analysis showed that hearing aid use was not associated with hospitalization (OR, 1.17; 95% CI, 0.74-1.84), including among respondents with moderate or severe hearing loss (OR, 1.17; 95% CI, 0.71-1.92).
CONCLUSIONS AND RELEVANCE
In this cross-sectional study, hearing loss was associated with higher risk of hospitalization, but hearing aid use was not associated with a reduction in hospitalization risk in the population with hearing loss. The association of hearing aid use with hospitalization should be evaluated in larger prospective studies with reliable data on the frequency of hearing aid use.
重要性
听力损失与老年人住院风险增加有关。然而，关于听力损失患者使用助听器是否与住院次数减少相关的证据仍然有限。
目的
评估听力损失严重程度和助听器使用与住院之间的关系。
设计、地点和参与者：本基于人群的横断面研究使用了 2005 年至 2016 年全国健康与营养调查的 4 个周期中年龄在 65 岁及以上的受访者的听力测量和医疗保健利用数据。数据分析于 2022 年 2 月 23 日至 3 月 22 日进行。
暴露
听力损失严重程度和参与者报告的助听器使用情况。
主要结果和措施
主要结果是受访者在过去 12 个月内报告的住院情况。采用多变量逻辑回归评估听力损失严重程度与住院的关系。为了评估助听器使用与住院的关系，采用倾向评分匹配进行了 2:1 最近邻无替换匹配。
结果
在 2060 名受访者（平均[SD]年龄，73.9[5.9]岁；1045[50.7%]为男性）中，875 名（42.5%）听力正常，653 名（31.7%）有轻度听力损失，435 名（21.1%）有中度听力损失，97 名（4.7%）有重度至极重度听力损失。多变量分析显示，中度和重度听力损失与住院有关（中度听力损失：比值比[OR]，1.50；95%置信区间[CI]，1.01-2.24；重度听力损失：OR，1.71；95%CI，1.03-2.84）。在至少有轻度听力损失的 1185 名受访者中，有 200 名（16.9%）报告使用了助听器。倾向评分匹配分析显示，助听器的使用与住院无关（OR，1.17；95%CI，0.74-1.84），包括中度或重度听力损失的受访者（OR，1.17；95%CI，0.71-1.92）。
结论和相关性
在这项横断面研究中，听力损失与住院风险增加有关，但听力损失人群中使用助听器与降低住院风险无关。应在更大的前瞻性研究中评估助听器使用与住院的关系，这些研究应具有助听器使用频率的可靠数据。
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