Dataset Information

Gout and hearing impairment in the elderly: a retrospective cohort study using the US Medicare claims data.

ABSTRACT: OBJECTIVES:To evaluate whether gout is associated with a higher risk of hearing loss in older adults. DESIGN:Retrospective cohort study. SETTING:USA. PARTICIPANTS:5% random sample of US Medicare claims 2006-2012, representative of US adults aged 65 years or older. PRIMARY AND SECONDARY OUTCOMES:Incident (new) hearing loss identified by the presence of at least two claims at least 4 weeks apart with an International Classification of Diseases, Ninth Revision, 389.xx, with no respective claim in the baseline 1-year observation period. RESULTS:Among the 1.71?million eligible people, 89?409 developed incident hearing impairment. The crude incidence rates of incident hearing impairment in people with versus without gout were 16.9 vs. 8.7 per 1000 person-years. Using Cox regression analyses adjusted for demographics, medical comorbidity and common cardiovascular and gout medications, we found that gout was associated with a significantly higher HR of incident hearing impairment, HR was 1.44 (95% CI 1.40 to 1.49, p<0.0001). Findings were confirmed in sensitivity analyses that substituted continuous Charlson-Romano Index with categorical variable or all comorbidities and additionally cardiovascular risk factors, with minimal attenuation of HR. CONCLUSIONS:Gout is associated with a higher risk of development of hearing loss in older adults. Future studies need to assess the underlying mechanisms of this association.

SUBMITTER: Singh JA

PROVIDER: S-EPMC6104764 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Gout and hearing impairment in the elderly: a retrospective cohort study using the US Medicare claims data.

Singh Jasvinder A JA Cleveland John D JD

BMJ open 20180820 8

<h4>Objectives</h4>To evaluate whether gout is associated with a higher risk of hearing loss in older adults.<h4>Design</h4>Retrospective cohort study.<h4>Setting</h4>USA.<h4>Participants</h4>5% random sample of US Medicare claims 2006-2012, representative of US adults aged 65 years or older.<h4>Primary and secondary outcomes</h4>Incident (new) hearing loss identified by the presence of at least two claims at least 4 weeks apart with an International Classification of Diseases, Ninth Revision, 3 ...[more]

PMID: 30127053

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Project description:BackgroundPostmenopausal bleeding (PMB) is a common gynecologic condition. Although it can be a sign of uterine cancer, most patients have benign etiology. However, research on quality of diagnostic evaluation for PMB has been limited to cancer patients. To extend this research, we examined the timeliness of diagnostic evaluation for PMB among patients with benign conditions.MethodsUsing the 2008-2019 MarketScan Research Databases, we identified 499176 patients (456741 with commercial insurance and 42435 with Medicaid insurance) who presented with PMB but did not have gynecologic cancer. For each patient, we measured the time from their PMB reporting to the date of their first diagnostic procedure. The association between patient characteristics and time to first diagnostic procedure was examined using Cox proportional hazards models (for the overall sample and then stratified by insurance type).ResultsOverall, 54.3% of patients received a diagnostic procedure on the same day when they reported PMB and 86.6% received a diagnostic procedure within 12 months after reporting PMB. These percentages were 39.4% and 77.1%, respectively, for Medicaid patients, compared to 55.7% and 87.4%, respectively, for commercially insured patients (p<0.001 for both). Medicaid patients had an 18% lower rate of receiving a diagnostic procedure at any given time point than commercially insured patients (adjusted hazard ratio = 0.82, 95% CI: 0.81-0.83). Meanwhile, older age and non-gynecologic comorbidities were associated with a lower rate whereas concomitant gynecologic conditions and recent use of preventive care were associated with a higher rate of receiving diagnostic procedures. Analysis stratified by insurance type identified additional risk factors for delayed diagnostic procedures (e.g., non-metropolitan versus metropolitan location for commercially insured patients and Black versus White race for Medicaid patients).ConclusionA sizable proportion of patients did not receive prompt diagnostic evaluation for PMB. Both clinical and non-clinical factors could affect timeliness of evaluation.

Dataset Information

Gout and hearing impairment in the elderly: a retrospective cohort study using the US Medicare claims data.

Publications

Gout and hearing impairment in the elderly: a retrospective cohort study using the US Medicare claims data.

Similar Datasets

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