Patient Characteristics Associated With Speech Recognition and Quality of Life Improvement After Cochlear Implantation

Objective: To identify patient characteristics associated with improvements in speech recognition scores (SRS) and Cochlear Implant Quality of Life (CIQOL-35) scores following cochlear implantation. Study design: Multi-institutional prospective cohort. Setting: Tertiary medical centers. Patients: Two hundred thirty-five adult CI users with bilateral hearing loss. Main outcome measures: Pre-CI and 12-month post-CI CIQOL-35, CNC word (CNC), and AzBio quiet (AzBio) scores were obtained. On the basis of improvement beyond established minimally detectable change values for each CIQOL domain and 95% CIs of pre-CI SRS as compared with post-CI, the cohort was divided into 4 groups for each CIQOL domain/SRS pair: (A) CIQOL and SRS improvement, (B) CIQOL improvement only, (C) SRS improvement only, and (D) no CIQOL or SRS improvement. Results: Correlations between CIQOL and SRS improvements were weak ( r =0.02–0.17). Grouped by CIQOL-Global/AzBio after 12 months post-CI, 51% of patients were classified as Group A, 4% as Group B, 39% as Group C, and 7% as Group D; percentages were similar for CIQOL-Global/CNC outcomes. Patients without CIQOL improvement had higher pre-CI CIQOL scores than patients who improved ( d =0.58–2.19), and patients without SRS improvement had higher pre-CI SRS scores than patients who improved (CNC: d =1.35–2.89, AzBio: d =1.09–2.78). Patients in Group D for the Entertainment domain were older than patients in Group A. Other patient factors were not significantly associated with the odds of improvement. Conclusions: Patients with higher baseline scores for a given outcome measure are less likely to improve following cochlear implantation. SRS and CIQOL score improvements were weakly correlated. The vast majority of patients (93%) improved in one or both outcome measures.