biostudies-literatureDang SNIDCD NIH HHSe281-e288https://www.ebi.ac.uk/biostudies/studies/S-EPMC10939851biostudies-literatureUnknown45(4)<h4>Objective</h4>To examine the association between preoperative comorbidities and cochlear implant speech outcomes.<h4>Study design</h4>Retrospective cohort.<h4>Setting</h4>Tertiary referral center.<h4>Patients</h4>A total of 976 patients who underwent cochlear implantation (CI) between January 2015 and May 2022. Adult patients with follow-up, preoperative audiologic data, and a standardized anesthesia preoperative note were included.<h4>Exposure</h4>Adult Comorbidity Evaluation 27 (ACE-27) based on standardized anesthesia preoperative notes.<h4>Main outcome measures</h4>Postoperative change in consonant-nucleus-consonant (CNC) score, AzBio Sentence score in quiet, and AzBio + 10 dB signal-to-noise ratio (SNR). Sentence score of the implanted ear at 3, 6, and 12 months.<h4>Results</h4>A total of 560 patients met inclusion criteria; 112 patients (20%) had no comorbidity, 204 patients (36.4%) had mild comorbidities, 161 patients (28.8%) had moderate comorbidities, and 83 patients (14.8%) had severe comorbidities. Mixed model analysis revealed all comorbidity groups achieved a clinically meaningful improvement in all speech outcome measures over time. This improvement was significantly different between comorbidity groups over time for AzBio Quiet ( p = 0.045) and AzBio + 10 dB SNR ( p = 0.0096). Patients with severe comorbidities had worse outcomes. From preop to 12 months, the estimated marginal mean difference values (95% confidence interval) between the no comorbidity group and the severe comorbidity group were 52.3 (45.7-58.9) and 32.5 (24.6-40.5), respectively, for AzBio Quiet; 39.5 (33.8-45.2) and 21.2 (13.6-28.7), respectively, for AzBio + 10 dB SNR; and 43.9 (38.7-49.0) and 31.1 (24.8-37.4), respectively, for CNC.<h4>Conclusions</h4>Comorbidities as assessed by ACE-27 are associated with CI performance. Patients with more severe comorbidities have clinically meaningful improvement but have worse outcome compared to patients with no comorbidities.Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and NeurotologyIndividual Patient Comorbidities and Effect on Cochlear Implant Performance.PMC10939851L30 DC020597R25 DC020706Varghese JBuchman CAPiccirillo JFWick CCDurakovic NHerzog JALee DShew MABao JWYoussef SDizdar KDang SKallogjeri DWalia AZhan KfalseIndividual Patient Comorbidities and Effect on Cochlear Implant Performance.<h4>Objective</h4>To examine the association between preoperative comorbidities and cochlear implant speech outcomes.<h4>Study design</h4>Retrospective cohort.<h4>Setting</h4>Tertiary referral center.<h4>Patients</h4>A total of 976 patients who underwent cochlear implantation (CI) between January 2015 and May 2022. Adult patients with follow-up, preoperative audiologic data, and a standardized anesthesia preoperative note were included.<h4>Exposure</h4>Adult Comorbidity Evaluation 27 (ACE-27) based on standardized anesthesia preoperative notes.<h4>Main outcome measures</h4>Postoperative change in consonant-nucleus-consonant (CNC) score, AzBio Sentence score in quiet, and AzBio + 10 dB signal-to-noise ratio (SNR). Sentence score of the implanted ear at 3, 6, and 12 months.<h4>Results</h4>A total of 560 patients met inclusion criteria; 112 patients (20%) had no comorbidity, 204 patients (36.4%) had mild comorbidities, 161 patients (28.8%) had moderate comorbidities, and 83 patients (14.8%) had severe comorbidities. Mixed model analysis revealed all comorbidity groups achieved a clinically meaningful improvement in all speech outcome measures over time. This improvement was significantly different between comorbidity groups over time for AzBio Quiet ( p = 0.045) and AzBio + 10 dB SNR ( p = 0.0096). Patients with severe comorbidities had worse outcomes. From preop to 12 months, the estimated marginal mean difference values (95% confidence interval) between the no comorbidity group and the severe comorbidity group were 52.3 (45.7-58.9) and 32.5 (24.6-40.5), respectively, for AzBio Quiet; 39.5 (33.8-45.2) and 21.2 (13.6-28.7), respectively, for AzBio + 10 dB SNR; and 43.9 (38.7-49.0) and 31.1 (24.8-37.4), respectively, for CNC.<h4>Conclusions</h4>Comorbidities as assessed by ACE-27 are associated with CI performance. Patients with more severe comorbidities have clinically meaningful improvement but have worse outcome compared to patients with no comorbidities.2024-01-01T00:00:00Z2024 Apr2025-07-13T03:04:26.636Z2025-07-13T03:04:26.636ZS-EPMC109398513843781610.1097/MAO.000000000000414410.1097/mao.0000000000004144