The Association Between Dehydration and the Prognosis of Sudden Sensorineural Hearing Loss

Yasunori Abe, Masahiro Okada, Keiko Tanaka, Kensuke Toyama, Yoshito Miyamoto, Naohito Hato
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Abstract

Background: There is an urgent need to identify undetermined risk factors for sudden sensorineural hearing loss (SSNHL) for the development of effective treatment strategies. SSNHL is likely associated with vascular insufficiency; however, no study has evaluated the relationship between dehydration and SSNHL. Objective: This study aimed to investigate the role of dehydration in the development and prognosis of sudden sensorineural hearing loss. Study Design: Retrospective case-control study. Setting: Secondary referral hospital. Patients and Interventions: This was a comparative study that compared dehydration parameters between healthy subjects without SSNHL (n = 94) and patients with SSNHL (n = 94). The study also evaluated the effect of dehydrated conditions on the prognosis of SSNHL. Main Outcome Measures: We compared dehydration parameters, such as the blood urea nitrogen-to-creatinine ratio (BUN/Cre) and plasma osmolality (Posm), between matched healthy subjects without SSNHL and patients with SSNHL. To evaluate the effect of dehydrated conditions on the SSNHL prognosis, the SSNHL patients were divided into 2 groups based on the cutoff value obtained from the receiver operating characteristic analysis: hydrated (n = 50; BUN/Cre <21.4) and dehydrated (n = 44; BUN/Cre ≥21.4) groups. Subsequently, the severity and prognosis of SSNHL were analyzed. Results: The dehydration parameters, BUN/Cre and Posm, were significantly higher in patients with SSNHL than in healthy subjects. The initial hearing levels and SSNHL grades were worse in the dehydrated group than in the hydrated group. Moreover, a dehydrated condition (BUN/Cre ≥21.4) was associated with a poor SSNHL prognosis in all models of the multiple logistic regression analysis. Conclusions: The dehydration parameters of BUN/Cre and Posm were higher in patients with SSNHL than in healthy subjects. Additionally, a dehydrated condition (BUN/Cre ≥21.4) was an independent prognostic factor for SSNHL. Level of evidence: Level 4.
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突发性感音神经性听力损失的脱水与预后的关系
背景:为了制定有效的治疗策略,迫切需要确定突发性感音神经性听力损失(SSNHL)的未确定危险因素。SSNHL可能与血管功能不全有关;然而,没有研究评估脱水与SSNHL之间的关系。目的:探讨脱水在突发性感音神经性听力损失发生及预后中的作用。研究设计:回顾性病例对照研究。环境:二级转诊医院。患者和干预措施:这是一项比较研究,比较了无SSNHL的健康受试者(n = 94)和SSNHL患者(n = 94)的脱水参数。本研究还评估了脱水条件对SSNHL预后的影响。主要结局指标:我们比较了无SSNHL的健康受试者和SSNHL患者的脱水参数,如血尿素氮与肌酐比(BUN/Cre)和血浆渗透压(Posm)。为了评估脱水情况对SSNHL预后的影响,根据受试者工作特征分析得出的截断值将SSNHL患者分为两组:脱水(n = 50;BUN/Cre <21.4)和脱水(n = 44;BUN/Cre≥21.4)组。随后分析SSNHL的严重程度和预后。结果:SSNHL患者脱水参数BUN/Cre和Posm明显高于健康人。脱水组患者的初始听力水平和SSNHL分级均低于水合组。此外,在多元logistic回归分析的所有模型中,脱水状态(BUN/Cre≥21.4)与SSNHL预后不良相关。结论:SSNHL患者BUN/Cre和Posm的脱水参数均高于健康人。此外,脱水状态(BUN/Cre≥21.4)是SSNHL的独立预后因素。证据等级:四级。
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