Assessing cochlear implant outcomes in older adults using HERMES: A national web-based database

Objective: Cochlear implant (CI) outcomes research has been largely limited to retrospective or single-institution studies in the United States. The objective is to demonstrate the feasibility of using a novel, national, web-based CI database through evaluating CI outcomes in older adults. Study Design: Analysis of a prospective, national, webbased database designed for CI outcome tracking (HERMES; HIPAA-secure, Encrypted, Research Management and Evaluation Solution). Setting: Multi-centered at 18 private practice and academic US medical centers. Patients: Older (age ≥75, n=47) or younger (age <75, n=103) adult CI patients (n=150 total, n=160 ears). Main Outcome Measure(s): Arizona Biomedical (AzBio), CI usage, postoperative complications. Results: Older adults had slightly lower performance on most recent AzBio (56.0%, n=26, 12.2±6.5 mo postoperatively) compared with younger adults (74.0%, n=52, 12.6±6.5 mo postoperatively; p<0.01, Mann-Whitney). However, on multiple regression, age was not a significant predictor of AzBio scores after controlling for sex, hearing loss duration, use, and postoperative follow-up duration. Most recent CI use was similar but significantly different (11.4 h/d in older, n=24 versus 13.0 in younger, n=45; p=0.01). Usage also did not decline over time ( p=0.81 in older versus p=0.46, in younger). The most common complications were similar (vertigo 25 versus 20%, p=0.45; tinnitus 4 versus 4%, p=0.93) in older and younger adults, respectively. Conclusion: We demonstrate the feasibility of a novel userfriendly, web-based, national CI database to analyze CI outcomes. Older age was not a significant predictor of AzBio scores after adjusting for multiple factors. Additionally, CI use did not decline over time.