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Risk of Sudden Sensorineural Hearing Loss in Stroke Patients: A 5-year Nationwide Investigation of 44,460 Patients

Presenting Author: Nancy Chang

Published online by Cambridge University Press:  03 June 2016

Nancy Chang ,
Chin-Lung Kuo  and
An-Suey Shiao
Nancy Chang
Affiliation:
Taipei Veterans General Hospital
Chin-Lung Kuo
Affiliation:
Department of Otolaryngology, Hsinchu Armed Force Hospital
An-Suey Shiao
Affiliation:
Department of Otolaryngology, Taipei Veterans General Hospital
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Abstract

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Learning Objectives: Post-stroke 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.

Objective: Post-stroke 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.

Methods: The Taiwan Longitudinal Health Insurance Database was used to compile data from 11,115 stroke patients and a comparison cohort of 33,345 matched non-stroke 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.

Results: 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 non-stroke patients (1.19 and 0.63/1000 person-years, respectively). Stroke patients had a 71% increased risk of SSNHL, compared to non-stroke patients (adjusted hazard ratio (HR) = 1.71, 95% CI = 1.24–2.36). We also observed a remarkable increase in risk of SSNHL in stroke patients (1) within one-year follow-up (adjusted HR = 5.65, 95% CI = 3.07–10.41) or (2) under steroid therapy during hospitalization (adjusted HR = 5.14, 95% CI = 2.08–12.75).

Conclusions: Patients with stroke had a higher risk of subsequent SSNHL compared to patients without stroke. In particular, stroke patients within one-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.