Cochlear implant: youngest children have greatest infection risk

  • Lander DP & al.
  • JAMA
  • 14 ene. 2020

  • de Emily Willingham, PhD
  • Clinical Essentials
El acceso al contenido completo es sólo para profesionales sanitarios registrados. El acceso al contenido completo es sólo para profesionales sanitarios registrados.

Takeaway

  • Among cochlear implant recipients, the youngest children (ages 1-2 years) have the highest rates of infectious complications.

Why this matters

  • These authors say that the absolute risk is quite low and is outweighed by the benefits from implants for language development.

Key results

  • Median age at implantation: 4 (interquartile range, 2-8) years.
  • 3.2% had infectious complications.
  • Rate was 8.2 (95% CI, 6.6-10.2) complications per 1000 person-years.
  • Highest rates were among children ages 1 and 2 years:
    • Age 1 year: 15.4 per 1000 person-years.
    • Age 2 years: 14.8 per 1000 person-years.
  • Adults in this study had similar rates, regardless of age, and an overall rate of 5.2 per 1000 person-years.
  • The most common infectious complication was prosthetic infection/inflammation (40% of cases).
  • Meningitis cases were rare (n

Study design

  • Retrospective cohort study, US state databases, including all implant recipients age 1 year or more (1975 children, 5474 adults).
  • Funding: National Institute on Deafness and Other Communication Disorders; others.

Limitations

  • Limited sensitivity for outpatient or nonsurgical complications.
  • Diagnostic codes (ICD) for infectious complications not validated in other studies.