Evaluating a Prediction Model for Infant Hearing Loss

作者：Lieu Judith E C^*; Ratnaraj Felicia; Ead Banan

来源：Laryngoscope, 2013, 123(11): 2873-2879.

DOI：10.1002/lary.24033

• Hearing loss
• infant
• prediction
• risk factors
• newborn hearing screening
• auditory brainstem response

Objectives/HypothesisThe objective of this study was to determine whether a prognostic model using risk factors for hearing loss could predict the chance that infants who failed a newborn hearing screen would subsequently be found to have hearing loss diagnosed by auditory brainstem response testing.
Study DesignIndividual retrospective case-control study.
MethodsWe studied 229 infants with hearing loss compared with 458 infants with normal hearing. All infants had undergone natural sleep or sedated auditory brainstem response, predominantly for not passing a newborn hearing screen. Risk factors, birth history, and other information were extracted via medical record review. Multiple logistic regression analyses identified independent predictors of hearing loss.
ResultsFour risk factors were independently predictive of hearing loss diagnosed by sleep or sedated auditory brainstem response: prematurity, 5-minute APGAR score6, intracranial complication, and craniofacial abnormality. A prognostic model developed from these risk factors was associated with a 15% rate of hearing loss in stage I, 52% rate of hearing loss in stage II, and 96% rate of hearing loss in stage III.
ConclusionsThe presence of any one of four independently predictive risk factors in infants who did not pass newborn hearing screen was associated with a 50% rate of hearing loss; having three or more was associated with a 90% rate of hearing loss. Knowing that an infant is at high risk of hearing loss can motivate parents to follow up with diagnostic auditory brainstem response testing so that early identification can lead to early intervention.
Level of Evidence2b. Laryngoscope, 123:2873-2879, 2013

• 出版日期2013-11