Table 2.
Clinical outcomes by hearing loss status.
| Outcome | Hearing loss | No hearing loss | Age-sex adjusted (baseline) | Fully adjusted (baseline) | Fully adjusted (time-varying) |
|---|---|---|---|---|---|
| Events (%) | (95% CI) | ||||
| All-cause mortality | 25,206 (16.5) | 304,391 (6.7) | 1.79 (1.76, 1.81) | 1.25 (1.23, 1.27) | 1.00 (0.99, 1.02) |
| Acute MI | 4904 (3.2) | 63,283 (1.4) | 1.42 (1.38, 1.47) | 1.10 (1.07, 1.13) | 1.03 (0.997, 1.06) |
| Stroke/TIA | 18,248 (12.2) | 201,441 (4.4) | 1.82 (1.80, 1.85) | 1.37 (1.35, 1.39) | 1.24 (1.22, 1.26) |
| Depression | 37,717 (27.6) | 935,758 (20.4) | 2.10 (1.98, 2.22) | 1.48 (1.40, 1.57) | 1.16 (1.14, 1.17) |
| New heart failure | 13,667 (9.3) | 145,881 (3.2) | 1.73 (1.70, 1.76) | 1.27 (1.25, 1.29) | 1.10 (1.08, 1.12) |
| New dementia | 15,177 (10.1) | 122,619 (2.7) | 2.16 (2.12, 2.20) | 1.61 (1.59, 1.64) | 1.41 (1.38, 1.43) |
| New LTC placement | 7204 (4.7) | 55,500 (1.2) | 1.91 (1.82, 2.00) | 1.46 (1.39, 1.53) | 1.07 (1.04, 1.10) |
| Events (rate/100py) | RR (95% CI) | ||||
| Days in hospital | 3,152,557 (204.4) | 37,802,674 (75.1) | 5.50 (3.50, 8.62) | 1.65 (1.39, 1.97) | 1.33 (1.16, 1.52) |
| Emergency visits | 1,025,983 (66.5) | 20,711,479 (41.1) | 1.65 (1.51, 1.79) | 1.21 (1.14, 1.28) | 1.14 (1.11, 1.18) |
| Potentially preventable | 236,743 (15.3) | 3,694,971 (7.3) | 2.47 (2.16, 2.81) | 1.37 (1.29, 1.47) | 1.12 (1.08, 1.17) |
| Low acuity | 66,029 (4.3) | 1,001,485 (2.0) | 2.79 (2.43, 3.19) | 1.63 (1.51, 1.75) | 1.15 (1.09, 1.22) |
| Other | 723,211 (46.9) | 16,015,023 (31.8) | 1.42 (1.33, 1.51) | 1.09 (1.05, 1.13) | 1.11 (1.08, 1.15) |
| Adverse drug events | 12,080 (0.8) | 157,941 (0.3) | 3.05 (2.52, 3.70) | 1.40 (1.35, 1.45) | 1.08 (1.04, 1.12) |
| Pressure ulcer | 716 (0.05) | 9244 (0.02) | 1.14 (0.89, 1.38) | 1.39 (1.21, 1.60) | 0.97 (0.85, 1.11) |
| Fall | 17,252 (1.1) | 173,942 (0.3) | 4.20 (3.27, 5.40) | 1.72 (1.59, 1.86) | 1.28 (1.21, 1.35) |
MI, Myocardial infarction; HR, Hazard ratio; LTC, Long-term care; PY, Patient-year; RR Rate ratio; TIA, Transient ischemic attack.
All models treat HL as a time-varying covariate, and thus events occurring any time within the study period prior to HL were included in the no-HL group and after hearing loss in the HL group.
We divided participants into age-sex strata where age was grouped into 5-year intervals. In the Weibull model, HR or RR (95% CI) are reported as appropriate. All-cause mortality, AMI, stroke/TIA, new HF (in those without heart failure), new dementia (in those without dementia) and new LTC placement (in those not in care) were regressed on time-varying hearing loss using Weibull regression with shared frailty modelled in 5-year age and sex groups. Length of hospital stays, ED visits, ADEs, pressure ulcers, and falls were regressed on time-varying hearing loss using negative binomial regression where the clustered sandwich estimator was used for variance estimation in the 5-year age and sex groups.
The other two models were further adjusted for rural residence status, material deprivation quintiles, obesity, hypertension, chronic pain, depression, chronic pulmonary disease, diabetes mellitus, hypothyroidism, osteoporosis, gout, stroke or TIA, fragility fractures, heart failure, cancer, asthma, alcohol misuse, coronary artery disease, atrial fibrillation, irritable bowel syndrome, rheumatic diseases, epilepsy, dementia, schizophrenia, inflammatory bowel disease, multiple sclerosis, severe constipation, peripheral artery disease, Parkinson's disease, psoriasis, severe chronic kidney disease, peptic ulcer disease, and chronic liver disease.
The adjusted (baseline) model used these covariates as assessed at baseline, whereas the adjusted (time-varying) model updated the covariates throughout follow-up.
Bold values indicate statistically significant at p < 0.05.