Malignant Otitis Externa Outcomes: A Study of the University HealthSystem Consortium Database

Jonathan L. Hatch, Michael J. Bauschard, Shaun A. Nguyen, Paul R. Lambert, Ted A. Meyer, Theodore R. McRackan

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective: To characterize factors that affect outcomes for patients with malignant otitis externa (MOE). Methods: Retrospective review of inpatients with MOE was performed. Patient demographics, comorbid conditions, complications, procedures, and mortalities were analyzed. Results: A total of 786 patients with MOE were identified. The mean hospitalization length of stay (LOS) was 18.6 days (SD = 19.7). The overall mortality rate was 2.5% (n = 20), and complication rate was 4.3% (n = 34). Increasing age significantly and positively correlated with the incidence of MOE (r = 0.979, P <.0001). Factors that were associated with an increased rate of mortality were sepsis (odds ratio [OR] = 18.5; ES = 0.94; 95% CI, 0.47-1.42), congestive heart failure (OR = 3.1; ES = 0.42; 95% CI, 0.02-0.82), weight loss (OR = 10.2; ES = 1.23; 95% CI, 0.61-1.85), and coagulopathy (OR = 8.8; ES = 1.84; 95% CI, 0.91-2.77). Surgical intervention was performed in 19.2% (n = 151) of patients. Facial nerve involvement was present in 15.5% (n = 122) of patients and was associated with a significantly longer LOS of 12.9 days (SD = 19.6; ES = 0.21; 95% CI, 0.03-0.41). Conclusions: This large multi-institutional database study of MOE demonstrates that several patient factors impact the LOS and mortality. Patients at risk for unfavorable outcomes include the elderly, male gender, comorbidities, or cranial nerve involvement.

Original languageEnglish (US)
Pages (from-to)514-520
Number of pages7
JournalAnnals of Otology, Rhinology and Laryngology
Volume127
Issue number8
DOIs
StatePublished - Aug 1 2018

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Otitis Externa
Outcome Assessment (Health Care)
Databases
Odds Ratio
Length of Stay
Mortality
Cranial Nerves
Facial Nerve
Comorbidity
Weight Loss
Inpatients
Sepsis
Hospitalization
Heart Failure
Demography
Incidence

Keywords

  • cranial nerve paralysis
  • malignant otitis externa
  • miscellaneous
  • morbidity
  • necrotizing otitis externa
  • osteomyelitis

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Malignant Otitis Externa Outcomes : A Study of the University HealthSystem Consortium Database. / Hatch, Jonathan L.; Bauschard, Michael J.; Nguyen, Shaun A.; Lambert, Paul R.; Meyer, Ted A.; McRackan, Theodore R.

In: Annals of Otology, Rhinology and Laryngology, Vol. 127, No. 8, 01.08.2018, p. 514-520.

Research output: Contribution to journalArticle

Hatch, Jonathan L. ; Bauschard, Michael J. ; Nguyen, Shaun A. ; Lambert, Paul R. ; Meyer, Ted A. ; McRackan, Theodore R. / Malignant Otitis Externa Outcomes : A Study of the University HealthSystem Consortium Database. In: Annals of Otology, Rhinology and Laryngology. 2018 ; Vol. 127, No. 8. pp. 514-520.
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abstract = "Objective: To characterize factors that affect outcomes for patients with malignant otitis externa (MOE). Methods: Retrospective review of inpatients with MOE was performed. Patient demographics, comorbid conditions, complications, procedures, and mortalities were analyzed. Results: A total of 786 patients with MOE were identified. The mean hospitalization length of stay (LOS) was 18.6 days (SD = 19.7). The overall mortality rate was 2.5{\%} (n = 20), and complication rate was 4.3{\%} (n = 34). Increasing age significantly and positively correlated with the incidence of MOE (r = 0.979, P <.0001). Factors that were associated with an increased rate of mortality were sepsis (odds ratio [OR] = 18.5; ES = 0.94; 95{\%} CI, 0.47-1.42), congestive heart failure (OR = 3.1; ES = 0.42; 95{\%} CI, 0.02-0.82), weight loss (OR = 10.2; ES = 1.23; 95{\%} CI, 0.61-1.85), and coagulopathy (OR = 8.8; ES = 1.84; 95{\%} CI, 0.91-2.77). Surgical intervention was performed in 19.2{\%} (n = 151) of patients. Facial nerve involvement was present in 15.5{\%} (n = 122) of patients and was associated with a significantly longer LOS of 12.9 days (SD = 19.6; ES = 0.21; 95{\%} CI, 0.03-0.41). Conclusions: This large multi-institutional database study of MOE demonstrates that several patient factors impact the LOS and mortality. Patients at risk for unfavorable outcomes include the elderly, male gender, comorbidities, or cranial nerve involvement.",
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T2 - A Study of the University HealthSystem Consortium Database

AU - Hatch, Jonathan L.

AU - Bauschard, Michael J.

AU - Nguyen, Shaun A.

AU - Lambert, Paul R.

AU - Meyer, Ted A.

AU - McRackan, Theodore R.

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N2 - Objective: To characterize factors that affect outcomes for patients with malignant otitis externa (MOE). Methods: Retrospective review of inpatients with MOE was performed. Patient demographics, comorbid conditions, complications, procedures, and mortalities were analyzed. Results: A total of 786 patients with MOE were identified. The mean hospitalization length of stay (LOS) was 18.6 days (SD = 19.7). The overall mortality rate was 2.5% (n = 20), and complication rate was 4.3% (n = 34). Increasing age significantly and positively correlated with the incidence of MOE (r = 0.979, P <.0001). Factors that were associated with an increased rate of mortality were sepsis (odds ratio [OR] = 18.5; ES = 0.94; 95% CI, 0.47-1.42), congestive heart failure (OR = 3.1; ES = 0.42; 95% CI, 0.02-0.82), weight loss (OR = 10.2; ES = 1.23; 95% CI, 0.61-1.85), and coagulopathy (OR = 8.8; ES = 1.84; 95% CI, 0.91-2.77). Surgical intervention was performed in 19.2% (n = 151) of patients. Facial nerve involvement was present in 15.5% (n = 122) of patients and was associated with a significantly longer LOS of 12.9 days (SD = 19.6; ES = 0.21; 95% CI, 0.03-0.41). Conclusions: This large multi-institutional database study of MOE demonstrates that several patient factors impact the LOS and mortality. Patients at risk for unfavorable outcomes include the elderly, male gender, comorbidities, or cranial nerve involvement.

AB - Objective: To characterize factors that affect outcomes for patients with malignant otitis externa (MOE). Methods: Retrospective review of inpatients with MOE was performed. Patient demographics, comorbid conditions, complications, procedures, and mortalities were analyzed. Results: A total of 786 patients with MOE were identified. The mean hospitalization length of stay (LOS) was 18.6 days (SD = 19.7). The overall mortality rate was 2.5% (n = 20), and complication rate was 4.3% (n = 34). Increasing age significantly and positively correlated with the incidence of MOE (r = 0.979, P <.0001). Factors that were associated with an increased rate of mortality were sepsis (odds ratio [OR] = 18.5; ES = 0.94; 95% CI, 0.47-1.42), congestive heart failure (OR = 3.1; ES = 0.42; 95% CI, 0.02-0.82), weight loss (OR = 10.2; ES = 1.23; 95% CI, 0.61-1.85), and coagulopathy (OR = 8.8; ES = 1.84; 95% CI, 0.91-2.77). Surgical intervention was performed in 19.2% (n = 151) of patients. Facial nerve involvement was present in 15.5% (n = 122) of patients and was associated with a significantly longer LOS of 12.9 days (SD = 19.6; ES = 0.21; 95% CI, 0.03-0.41). Conclusions: This large multi-institutional database study of MOE demonstrates that several patient factors impact the LOS and mortality. Patients at risk for unfavorable outcomes include the elderly, male gender, comorbidities, or cranial nerve involvement.

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KW - malignant otitis externa

KW - miscellaneous

KW - morbidity

KW - necrotizing otitis externa

KW - osteomyelitis

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