Wu PL, Lin HC, Chien WC, Chung CH, Chen JW. Increased Risk of Injury in Ménière's Disease and Effects of Treatment: Population-Based Retrospective Cohort Study.
Otolaryngol Head Neck Surg 2023;
168:443-452. [PMID:
35763347 DOI:
10.1177/01945998221106628]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/25/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE
To investigate the risk of injury in patients with Ménière's disease (MD) and the effects of treatment.
STUDY DESIGN
Population-based retrospective cohort study.
SETTING
Data were collected from the Longitudinal Health Insurance Database 2005, containing the information of 2 million randomly selected individuals in Taiwan.
METHODS
We enrolled 90,481 patients with newly diagnosed MD between 2000 and 2017 and 361,924 matched individuals without MD. The study outcomes were diagnoses of all-cause injuries. The Kaplan-Meier method was used to determine the cumulative incidence rates of injury in the MD and non-MD cohorts, and a log-rank test was used to analyze the differences between the cohorts. Cox proportional hazards models were used to calculate the 18-year hazard ratios of each cohort.
RESULTS
A total of 80,151 patients were diagnosed with injuries during the follow-up period: 24,031 and 56,120 from the MD and non-MD cohorts, respectively. The adjusted hazard ratio (aHR) was 2.19 (95% CI, 2.16-2.35) after adjusting for demographic characteristics and comorbidities. Subgroup analysis revealed that MD was associated with an increased incidence of unintentional and intentional injuries (aHR, 2.24 [95% CI, 2.21-2.41] and 2.05 [95% CI, 2.01-2.19], respectively). Treatment with diuretics, antivertigo medications, or surgery did not reduce the risk of injury (aHR, 0.98 [95% CI, 0.59-1.54], 0.94 [95% CI, 0.58-1.50], and 0.99 [95% CI, 0.61-1.54]).
CONCLUSION
MD is independently associated with an increased risk of injuries. Medical or surgical treatment for MD does not reduce the risk of injury in patients with MD. Physicians should counsel patients with MD regarding preventive measures for avoiding subsequent injuries.
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