Necrotizing Otitis Externa: Insights From a Nationwide Database on In-Hospital Outcomes and Characteristics

To evaluate demographic and hospital-related factors associated with length of stay (LOS) in patients hospitalized with necrotizing otitis externa (NOE).

Retrospective cohort study.

Nationwide Inpatient Sample (NIS), 2017 to 2019.

Patients with a primary diagnosis of NOE were identified from the NIS. Linear regression and additional statistical analyses were performed to assess associations between LOS and variables including age, gender, race, socioeconomic status, hospital type, and comorbidities such as diabetes.

A total of 3580 patients with NOE were included. Increased age was significantly associated with longer LOS (P < .001). Black patients had longer hospitalizations compared to white patients (6.1 vs 4.4 days, P < .001). Women were hospitalized at a younger age than men (54 vs 60 years, P < .001), while men had longer LOS (5.3 vs 4.6 days, P = .033). Patients treated in teaching hospitals and those without diabetes had longer LOS. Socioeconomic disparities were evident, with Black patients more likely to reside in lower-income ZIP code areas (χ² = 19.4, df = 3, P < .001). The number of diagnoses did not differ significantly between Black and non-Black patients (t = 0.758, df = 697, P = .449).

Elderly, male, Black patients and those treated at teaching hospitals tend to have longer hospitalizations for NOE. Women and non-diabetic patients are admitted at younger ages. These findings identify demographic and hospital-related factors that are associated with LOS and support the need for additional research to clarify the factors underlying these disparities.