Investigating Deferral Rates in Cochlear Implantation: How Often Do Candidates Defer and Why?
Vivian F. Kaul, Bryce P.G. Dzubara, Vikas Munjal, Juhi Katta, Oliver F. Adunka, Yin Ren- Neurology (clinical)
- Sensory Systems
- Otorhinolaryngology
Objective
Evaluate the rate at which cochlear implant (CI) candidates decline surgery and identify associated factors.
Study Design
Retrospective cohort study.
Setting
Tertiary referral center.
Patients
Four hundred ninety-three CI candidates from July 1989 to December 2020 with complete demographic and socioeconomic data.
Interventions
Diagnostic.
Main Outcome Measures
Age, sex, race, marital and employment status, median household income percentile, distance-to-CI-center, and residence in a medically underserved county.
Results
Of the 493 CI candidates included, 80 patients (16.2%) declined surgery. Based on chart checking, the most common reason patients did not receive the implant was due to loss of follow-up (38%). African American patients were 73% less likely to undergo implantation compared with White patients (odds ratio [OR], 0.27 [0.11–0.68];
Conclusions
Not infrequently, CI candidates decline surgery. Although demographic factors (race, age, and marital status) were associated with the cochlear implantation decision, socioeconomic factors (median family income and residence in a medically underserved community) were not. Perhaps cultural components of a patient's race have a larger impact on whether or not the patients get implanted.