Table 7.

Age-Adjusted Logistic Regression Models of Factors Associated with Cisplatin-Associated ASHA-Defined Hearing Loss Severity

Variable	OR (95% CI)	P value	Omnibus P value
Cumulative dose of cisplatin, mg/m²			0.0003 ^a
≤300	Ref.
>300	1.43 (1.18-1.74)	0.0003
Race			0.28
White	Ref.
African-American	1.25 (0.44-3.50)	0.67
Asian	1.53 (0.96-2.44)	0.08
Other	1.18 (0.80-1.74)	0.40
Education			0.0032 ^a
High school or less	Ref.
After high school but not college graduate	0.76 (0.53-1.10)	0.15
College or university graduate	0.83 (0.59-1.15)	0.26
Post-graduate	0.56 (0.39-0.80)	0.0015
Smoking status			0.88
Never	Ref.
Former	1.04 (0.85-1.29)	0.70
Current	0.95 (0.63-1.42)	0.79
Average no. alcoholic drinks in past year			0.46
Rarely or never	Ref.
≤ 4 per week	0.84 (0.65-1.10)	0.20
5 per week to 1 per day	0.79 (0.59-1.07)	0.12
≥ 2 daily	0.85 (0.59-1.21)	0.35
Body mass index, kg/m²			0.11 ^a
<25 (normal)	Ref.
25-29 (overweight)	1.25 (0.98-1.58)	0.07
≥ 30 (obese)	1.29 (0.99-1.67)	0.06
Waist circumference, cm			0.05 ^a
<102	Ref.
≥ 102	1.25 (1.01-1.56)	0.05
Engage in vigorous physical activity (≥ 6 METs)			0.73
No	Ref.
Yes	0.96 (0.78-1.19)	0.73
Physical activity (total MET-hours/week) quartiles			0.09 ^a
Quartile 1	Ref.
Quartile 2	0.74 (0.56-0.97)	0.03
Quartile 3	0.99 (0.76-1.31)	0.98
Quartile 4	0.84 (0.64-1.11)	0.23
Hypertension and on prescription medication (patient-reported) ^b			0.0003 ^a
No	Ref.
Yes	1.86 (1.33-2.59)	0.0003
Diabetes and on prescription medication ^c			0.76
No	Ref.
Yes	1.09 (0.62-1.91)	0.76
Hypercholesterolemia and on prescription medication ^d			0.47
No	Ref.
Yes	1.13 (0.81-1.58)	0.47
Cardiovascular disease ^e			0.31
No	Ref.
Yes	1.44 (0.71-2.90)	0.31
Noise exposure			0.12 ^a
No	Ref.
Yes	1.17 (0.96-1.42)	0.12

Abbreviations: CI, confidence interval; MET, metabolic equivalent task; OR, odds ratio; Ref., reference.

Note: Each row of analysis is derived from an ordinal regression model in which we report the effect for the primary independent variable of interest and adjust for age at audiometry.

Hearing loss was defined following methods in Frisina et al (Frisina et al. 2016) using American Speech-Language-Hearing Association criteria (ASHA) for frequencies of 4 through 12 kHz for which dose-response relationships with cumulative amount of cisplatin were shown (Frisina et al. 2016).

P values with boldface indicate significance at P<0.05.

Variables with Omnibus (Wald chi-square from type 3 analysis of effects) P≤0.25 were selected for inclusion in the final multivariable model.

Hypertension and on prescription medication was defined as answering “yes” to (1) have you ever been diagnosed with high blood pressure and “yes, current” to (2) have you ever taken prescription medications for high blood pressure (including current use) (Chunkit Fung et al. 2017).

Diabetes and on prescription medication was defined as answering “yes” to either of the following questions: (1) diabetes requiring insulin or (2) diabetes requiring tablets or pills (Chunkit Fung et al. 2017). This adverse health outcome was not available for 30 participants.

Hypercholesterolemia and on prescription medication defined as answered “yes, current” to the following question: have you ever taken prescription medications for high cholesterol (Chunkit Fung et al. 2017).

Includes coronary artery disease, heart failure, or cerebrovascular disease. The age-adjusted association between cardiovascular disease with ASHA-defined hearing loss severity did not meet the proportional odds assumption.