A Retrospective Cohort Study on the Influence of Comorbidity on Soft Tissue Reactions, Revision Surgery, and Implant Loss in Bone-anchored Hearing Implants

作者：den Besten Christine A^*; Nelissen Rik C; Peer Petronella G M; Faber Hubert T; Dun Catherina A J; de Wolf Maarten J F; Kunst Henricus P M; Cremers Cor W R J; Mylanus Emmanuel A M; Hol Myrthe K S

来源：Otology & Neurotology, 2015, 36(5): 812-818.

DOI：10.1097/mao.0000000000000745

• Baha
• Bone-anchored hearing implant
• Comorbidity
• Hearing loss
• Implant loss
• Revision surgery
• Risk factors
• Soft tissue reactions

Objective: To identify risk factors for complications after bone-anchored hearing implant (BAHI) surgery.
Study Design: Retrospective cohort study.
Setting: Tertiary referral center.
Patients: All adult patients who received titanium bone-anchored hearing implants at our clinic between September 1, 1988 and December 31, 2007 were approached to fill out a questionnaire on comorbidity factors. A total of 581 patients with 669 implants were included in the analysis.
Main Outcome Measures: Implant loss, soft tissue reactions, and revision surgery after BAHI implantation.
Results: Skin disease and profound learning difficulties were risk factors for time to first soft tissue reaction, hazard rate ratio of 3.41 (95% CI 1.45-8.01) and 3.42 (1.03-11.39), respectively. Female gender showed a trend toward a negative risk for time to first soft tissue reaction, hazard rate ratio 0.60 (0.35-1.03). In multivariable analysis, skin disease and female gender were observed as independent associative factors, adjusted hazard ratio 3.08 (1.32-7.16) and 0.56 (0.33-0.94). For revision surgery, female gender and cardiovascular disease were identified as negative risk factors in univariable analysis, and smoking showed a trend toward a negative risk, with hazard ratios of 0.15 (0.07-0.32), 0.07 (0.03-0.20), and 0.51 (0.24-1.07), respectively. In multivariable analysis, smoking and female gender were observed as independent associative factors, adjusted hazard ratio 0.45 (0.22-0.95) and 0.14 (0.06-0.30). Smoking could be identified as a risk factor for implant loss with a hazard ratio of 3.32 (1.36-8.09).
Conclusion: Retrospective analysis of comorbidity factors and clinical outcomes revealed risk factors for postoperative complications after BAHI surgery.

• 出版日期2015-6