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Incidence of Hip Fractures among Patients with Chronic Otitis Media: The Real-World Data
Pei-Shao Liao1, Ching-Chih Chiu2, Yi-Hsiu Fu3
1Department of Otolaryngology Head and Neck Surgery, China Medical University Hospital, Taichung 404327, Taiwan.
Insights
Chronic otitis media (COM) patients face an increased risk of hip fracture. This risk is even higher for COM patients with a history of hearing loss, suggesting a systemic link.
Area of Science:
- Otolaryngology
- Orthopedics
- Epidemiology
Background:
- Chronic otitis media (COM) is typically viewed as a localized ear condition.
- The systemic effects of COM, particularly concerning bone health and fracture risk, remain largely unexplored.
Purpose of the Study:
- To investigate the association between COM and the risk of hip fracture.
- To determine if COM-induced inflammation contributes to systemic bone loss and subsequent fractures.
Main Methods:
- A retrospective cohort study design was employed.
- Patients with COM were identified and compared to a control group matched for age, gender, and comorbidities (including osteoporosis) at a 1:2 ratio.
- Hip fracture incidence and cumulative incidence were analyzed.
Main Results:
- The cumulative incidence of hip fracture was significantly higher in the COM cohort (p < 0.001).
- Adjusted analysis revealed COM patients had a 1.11-fold increased risk of hip fracture (aHR = 1.11; 95% CI = 1.05−1.17).
- Within the COM group, a history of hearing loss was linked to a further increased fracture risk (aHR = 1.21; 95% CI = 1.20−1.42).
Conclusions:
- Chronic otitis media is associated with an elevated risk of hip fracture.
- The presence of hearing loss in COM patients further amplifies this fracture risk.
- Findings suggest a potential systemic impact of COM on bone metabolism and skeletal integrity.
Abstract:
Chronic otitis media (COM) has been considered as a localized disease, and its systemic impact is poorly understood. Whether COM-induced inflammation could be associated with systemic bone loss and hip fracture is unknown at present. Our study tried to determine the risk of hip fracture among COM patients. We selected the comparison individuals without the COM coding and paired the controls with COM patients by gender, age, and comorbidities (including osteoporosis) by about a one-to-two ratio. Our study showed that the incidence of hip fracture was 4.48 and 3.92 per 1000 person-years for comparison and COM cohorts respectively. The cumulative incidence of hip fracture is higher in the COM cohort (p < 0.001). After adjustment for gender, age, and comorbidities, the COM patients had a 1.11-fold (aHR = 1.11; 95% CI = 1.05−1.17) risk of hip fracture than the control subjects. Among COM patients, a history of hearing loss is associated with higher (aHR = 1.21; 95% CI = 1.20−1.42) fracture risk. Our study showed that COM patients, especially those with hearing loss, are susceptible to a higher risk for hip fracture.
