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Abstract
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OBJECTIVE: To examine whether cochlear implantation (CI) increases the risk of clinically significant falls in older adults. STUDY DESIGN: Retrospective analysis of deidentified administrative claims from a US commercial insurance database. SETTING: Nationwide deidentified private insurance claims database (Clinformatics Data Mart; Optum).
METHODS: Patients undergoing CI were identified through Current Procedural Terminology codes. Number of days with falls resulting in health care expenditure were counted 1 year pre- and post-CI. Generalized estimating equation Poisson regression was used to determine medical and sociodemographic predictors for fall days, including age, sex, race, and income, with pre- vs post-CI status.
RESULTS: Between 2003 and 2019, 3773 patients aged >50 years underwent CI. An overall 139 (3.68%) patients recorded at least 1 fall diagnosis a year pre-CI, and 142 (3.76%) recorded at least 1 fall diagnosis post-CI. The average number of days with fall diagnoses per patient with a recorded fall was 3.12 pre-CI and 2.04 post-CI. In bivariate analysis, age (P <.0001) and Charlson Comorbidity Index (P <.0001) were predictive of falls, but sex (P <.10), race (P <.72), and income (P <.51) were not. Poisson regression demonstrated a statistically significant association between Charlson Comorbidity Index and days with fall diagnoses (risk ratio, 1.39 [95% CI, 1.30-1.49]; P <.0001]). No statistically significant difference in falls was seen pre- vs post-CI (risk ratio, 0.67 [95% CI, 0.34-1.33]; P <.25]). Age also was not predictive of falls in multivariate analysis.
CONCLUSIONS: CI does not appear to increase the risk of falls in older adults. Patient comorbidities correlate most strongly with fall risk and should be considered in patient selection for CI.
Language: en |