Frailty and Steroid Treatment Outcomes in Patients with Sudden Sensorineural Hearing Loss

To investigate the relationship between frailty and steroid treatment outcomes in patients with sudden sensorineural hearing loss (SSNHL).

Retrospective cohort studySetting:Tertiary-care institution.

185 adult patients (≥19 years) with unilateral SSNHL presenting January 1, 2017 to May 24, 2023, stratified by 5-Factor Modified Frailty Index (mFI5).

Oral prednisone and/or intratympanic dexamethasone.

Post-treatment changes in pure-tone average (PTA), speech reception threshold (SRT), and word recognition scores (WRS).

Female and younger patients were significantly less frail than male and older patients (P = .004, P < .001 respectively). Patients with higher frailty scores (≥2) were less likely to receive oral steroids (59.6% vs 82.8%, P = .004), though equally likely to receive intratympanic steroids (P = 1.000). However, patients classified as frail (≥1) were not more likely to receive intratympanic steroids alone compared to combination therapy (P = .220). Higher frailty scores were significantly associated with metabolic syndrome (P = .002), but specific treatment patterns in diabetic patients could not be delineated as treatment was individualized. Dizziness (P = .650) and vertigo (P = .200) did not correlate with frailty or treatment outcomes. The number of comorbidities increased with higher frailty scores (P < .001) but did not directly correlate with SSNHL outcomes. No significant differences were observed in audiometric outcomes (PTA/SRT/WRS) based on patient frailty scores across all comparisons (P's > .05).

While we found an association between frailty scores and treatment selection for SSNHL, we did not find a significant association between frailty scores and treatment outcomes. Therefore, treatment may be individualized in frail patients without compromising audiometric outcomes.