Abstract Objective To investigate the association of frailty with post‐cochlear implant (CI) admission, morbidity, and CI‐aided word recognition outcomes in veterans. Study Design Retrospective cohort. Setting Single‐institution tertiary care Veterans Health Administration (VHA) hospital. Methods Veterans who underwent cochlear implantation between 1998 to 2024 were included. The Modified 5‐Item Frailty Index (mFI‐5) score was used to characterize preoperative frailty. Outcomes of interest were admission from post‐anesthesia care unit (PACU), relative risk (RR) of admission among frail patients, and relationship between frailty and post‐CI word recognition score (WRS). Ordinal data were analyzed via logistic regression and Chi square tests; a multivariate linear regression was used to assess nominal data. Significance was set at P < .05. Results Ninety‐one patients (median age 71 years, range 35‐92 years) resulted in 41 (39.4%) admissions out of 104 surgical encounters. Admission rate initially increased from 2016 to 2020 (48.9%), then decreased (29%) in 2021. Forty‐two (46%) patients met criteria as being frail, while 26 (28.6%) were prefrail. While frail patients were more readily admitted (43% vs 36%; RR 1.15) and had higher rates of dizziness (20% vs 15%; RR 1.23) when compared to the combined cohort of nonfrail and prefrail patients, these relationships were not significant. Preoperative frailty was significantly negatively associated with post‐CI WRS at 6‐ and 12‐month post‐CI in a multivariate analysis including patient age ( P < .05). Conclusion The prevalence of frailty is high among veterans undergoing cochlear implantation. Patient frailty is significantly associated with post‐CI speech recognition but did not appear to impact likelihood of admission or complications.
Brooks et al. (Sun,) studied this question.