Increasing Malignant Otitis Externa Admissions to U.S. Teaching Hospitals Over the Past 2 Decades

Area of Science:

• Otolaryngology
• Infectious Diseases
• Health Services Research

Background:

• Malignant otitis externa (MOE) is a severe infection primarily affecting elderly patients with diabetes.
• Understanding national trends in MOE hospitalization is crucial for resource allocation and patient care.

Purpose of the Study:

• To analyze national trends in malignant otitis externa (MOE) hospitalizations.
• To compare admission rates to teaching versus nonteaching hospitals for MOE patients.

Main Methods:

• Retrospective cohort study utilizing the National Inpatient Sample (NIS) database.
• Analysis of U.S. inpatient hospitalizations for adult MOE patients from 1998 to 2021.
• Multivariate logistic regression to identify factors associated with teaching hospital admissions and temporal trend analysis.

Main Results:

• MOE admissions to teaching hospitals surged by 290.6% from 1998-2021, while nonteaching hospital admissions declined by 55.8%.
• Teaching hospitals accounted for 57.7% of MOE admissions and treated patients with higher comorbidity burdens, including diabetes, HIV/AIDS, and metastatic cancer.
• Annual odds of teaching hospital admission increased by 8% over the study period.

Conclusions:

• MOE hospitalizations have significantly centralized in U.S. teaching hospitals over two decades.
• Academic centers manage MOE patients with greater medical complexity and immunocompromising conditions.
• Findings highlight critical issues in healthcare access, equity, and resource allocation for MOE care.