Patient Characteristics Associated With Speech Recognition and Quality of Life Improvement After Cochlear...

To identify patient characteristics associated with improvements in speech recognition scores (SRS) and Cochlear Implant Quality of Life (CIQOL-35) scores following cochlear implantation.

Multi-institutional prospective cohort.

Tertiary medical centers.

Two hundred thirty-five adult CI users with bilateral hearing loss.

Pre-CI and 12-month post-CI CIQOL-35, CNC word (CNC), and AzBio quiet (AzBio) scores were obtained. On the basis of improvement beyond established minimally detectable change values for each CIQOL domain and 95% CIs of pre-CI SRS as compared with post-CI, the cohort was divided into 4 groups for each CIQOL domain/SRS pair: (A) CIQOL and SRS improvement, (B) CIQOL improvement only, (C) SRS improvement only, and (D) no CIQOL or SRS improvement.

Correlations between CIQOL and SRS improvements were weak ( r =0.02-0.17). Grouped by CIQOL-Global/AzBio after 12 months post-CI, 51% of patients were classified as Group A, 4% as Group B, 39% as Group C, and 7% as Group D; percentages were similar for CIQOL-Global/CNC outcomes. Patients without CIQOL improvement had higher pre-CI CIQOL scores than patients who improved ( d =0.58-2.19), and patients without SRS improvement had higher pre-CI SRS scores than patients who improved (CNC: d =1.35-2.89, AzBio: d =1.09-2.78). Patients in Group D for the Entertainment domain were older than patients in Group A. Other patient factors were not significantly associated with the odds of improvement.

Patients with higher baseline scores for a given outcome measure are less likely to improve following cochlear implantation. SRS and CIQOL score improvements were weakly correlated. The vast majority of patients (93%) improved in one or both outcome measures.