scholarly journals Effect of initial switch-on within 24 hours of cochlear implantation using slim modiolar electrodes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Woongsang Sunwoo ◽  
Hyoung Won Jeon ◽  
Byung Yoon Choi
Keyword(s):  
Cohort Study ◽  
Cochlear Implants ◽  
Retrospective Cohort Study ◽  
Cochlear Implantation ◽  
Retrospective Cohort ◽  
Electrode Array ◽  
Electrode Impedance ◽  
Post Operation ◽  
Lower Impedance ◽  
Conventional Switch

AbstractReducing electrode impedance is an important factor in improving the functional benefits of cochlear implants (CIs). The immediate effect of early switch-on within 24 h of surgery on impedance among CI recipients with various types of electrodes has been reported previously; however, the immediate change and the evolution of electrode impedances of slim modiolar electrodes after early switch-on within 24 h of implantation has not. Therefore, the focus of this retrospective cohort study of CI patients was to compare the effect of early switch-on (n = 36) and conventional switch-on (n = 72) 2–4 weeks post-operation on impedance. Compared with impedance measured intraoperatively, our results demonstrate a significant decrease in impedance from 11.5 to 8.9 kΩ (p < 0.001) at 2–4 weeks after implantation in the early switch-on group, which sharply contrasted with elevated impedance values for conventional switch-on 2–4 weeks after implantation (from 10.7 to 14.2 kΩ, p = 0.001). Notably, a comparatively lower impedance than the conventional switch-on protocol was observed for up to 2 months post-operation. Most importantly, a much earlier stabilization of impedance can be achieved with the early switch-on protocol coupled with the slim modiolar electrode array compared to the conventional switch-on protocol, offering the advantage of reducing the number of required mapping sessions in the early stages of rehabilitation.

scholarly journals Effect of Initial Switch-On Within 24 Hours of Cochlear Implantation Using Slim Modiolar Electrodes: Potential Clinical Implications

2021 ◽  
Author(s):  
Woongsang Sunwoo ◽  
Hyoung Won Jeon ◽  
Byung Yoon Choi
Keyword(s):  
Cochlear Implants ◽  
Cochlear Implantation ◽  
Electrode Array ◽  
Clinical Implications ◽  
Electrode Impedance ◽  
Significant Drop ◽  
Early Stages ◽  
Post Operation ◽  
Lower Impedance ◽  
Conventional Switch

Abstract Reducing electrode impedance is an important factor in improving the functional benefits of cochlear implants (CIs). The immediate effect of early switch-on within 24 hours of surgery on impedance among CI recipients with various types of electrodes has been reported previously; however, the immediate change and the evolution of electrode impedances of slim modiolar electrodes after early switch-on within 24 hours of implantation has not. Therefore, the focus of this study was to compare the effect of early switch-on and conventional switch-on 3–4 weeks post-operation on impedance. Compared with impedance measured intraoperatively, our results demonstrate a significant drop in impedance for early switch-on, which sharply contrasted with elevated impedance values for conventional switch-on 3–4 weeks after implantation. Notably, a comparatively lower impedance than the conventional switch-on protocol was observed for up to 2 months post-operation. Most importantly, a much earlier stabilization of impedance can be achieved with the early switch-on protocol coupled with the slim modiolar electrode array compared to the conventional switch-on protocol, offering the advantage of reducing the number of required mapping sessions in the early stages of rehabilitation.

scholarly journals The incidence of stroke among patients undergoing elective posterior lumbar fusion: a retrospective cohort study

2019 ◽  
Author(s):  
Patrick Arena ◽  
Jingping Mo ◽  
Charu Sabharwal ◽  
Elizabeth Begier ◽  
Xiaofeng Zhou ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Lumbar Fusion ◽  
Index Hospitalization ◽  
Loss To Follow Up ◽  
Posterior Lumbar Fusion ◽  
Electronic Healthcare Record ◽  
Post Operation

Abstract Background: Although stroke is an uncommon but life-threatening complication among spinal surgery patients, the recognition of this adverse event is critical given the aging population undergoing surgical procedures. The objective of this study was to estimate the incidence of stroke among adults undergoing elective posterior lumbar fusion (PLF) during post-operative risk windows and among different subgroups. Methods: A retrospective cohort study using a longitudinal electronic healthcare record (EHR) database was conducted from January 1, 2007 to June 30, 2018. Elective PLF, stroke, and select clinical characteristics were defined based on International Classification of Disease codes. Patients aged 18 to 85 years with ≥ 183 days of enrollment in the database prior to undergoing elective PLF were followed from the index date until the occurrence of stroke, death, loss to follow-up, or end of study period, whichever occurred first. Incidence proportions (IPs) and rates (IRs) of stroke were estimated in the following risk windows: index hospitalization, ≤ 30 days, ≤ 90 days, ≤ 180 days, and ≤ 365 days post-operation Results: A total of 43,063 patients were eligible for the study. The IP of stroke following elective PLF ranged from 0.29% (95% confidence interval [CI]: 0.25%, 0.35%) during index hospitalization to 1.12% (95% CI: 1.03%, 1.23%) ≤ 365 days post-operation; the IR of stroke following elective PLF per 1000 person-years decreased consistently from 229.08 (95% CI: 192.38, 272.78) during index hospitalization to 13.68 (95% CI: 12.51, 14.96) ≤ 365 days post-operation. Stratified analyses revealed that older patients had a higher incidence of stroke. Additionally, black patients had higher stroke incidences than white, Asian, or other patients. Furthermore, the incidence of post-operative stroke was higher among patients with a history of type 2 diabetes than among patients without such history. Conclusions: The incidence of stroke following elective PLF found here using an EHR database is slightly higher than that reported in the literature; however, the discrepancy is due to differences in the variable definitions, study populations, follow-up periods, and data sources between our study and those in the literature.

scholarly journals The incidence of stroke among selected patients undergoing elective posterior lumbar fusion: a retrospective cohort study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Patrick J. Arena ◽  
Jingping Mo ◽  
Charu Sabharwal ◽  
Elizabeth Begier ◽  
Xiaofeng Zhou ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Lumbar Fusion ◽  
Index Hospitalization ◽  
Stroke Incidence ◽  
Posterior Lumbar Fusion ◽  
Post Operation ◽  
History Of

Abstract Background Although stroke is a rare complication among spinal surgery patients, the recognition of this adverse event is critical given the aging population undergoing surgical procedures. The objective of this study was to estimate the incidence of stroke among selected adults undergoing elective posterior lumbar fusion (PLF) during various post-operative risk windows and among different subgroups. Methods A retrospective cohort study using a longitudinal electronic healthcare record (EHR) database was conducted from January 1, 2007 to June 30, 2018. Elective PLF, stroke, and select clinical characteristics were defined based on International Classification of Disease codes. Patients aged 18 to 85 years with ≥183 days of enrollment in the database prior to undergoing elective PLF were followed from the index date until the occurrence of stroke, death, loss to follow-up, or end of study period, whichever occurred first. The incidence of stroke was estimated in the following risk windows: index hospitalization, ≤ 30 days, ≤ 90 days, ≤ 180 days, and ≤ 365 days post-operation. Results A total of 43,063 patients were eligible for the study. The incidence of stroke following elective PLF was 0.29% (95% confidence interval [CI]: 0.25, 0.35%) during index hospitalization, 0.44% (95% CI: 0.38, 0.50%) ≤ 30 days, 0.59% (95% CI: 0.52, 0.67%) ≤ 90 days, 0.76% (95% CI: 0.68, 0.85%) ≤ 180 days, and 1.12% (95% CI: 1.03, 1.23%) ≤ 365 days post-operation. Stratified analyses revealed that older patients had a higher incidence of stroke. Additionally, black patients had higher stroke incidences. Post-operative stroke incidence was higher among patients with a history of type 2 diabetes than among patients without such history; similarly, stroke incidence was higher among patients with a history of stroke compared to patients without such history. Conclusions The incidence of stroke following elective PLF using an EHR database in this study is slightly higher than that reported in the literature. Our results suggest that stroke risk modification prior to PLF may be important for patients who are older, black, type 2 diabetic, and/or have a history of stroke.

scholarly journals Predicting sequential bilateral cochlear implantation performance in postlingually deafened adults; A retrospective cohort study

2018 ◽  
Vol 43 (6) ◽  
pp. 1500-1507
Author(s):  
Yvette E. Smulders ◽  
Thomas Hendriks ◽  
Inge Stegeman ◽  
Robert H. Eikelboom ◽  
Cathy Sucher ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Cochlear Implantation ◽  
Retrospective Cohort

scholarly journals The incidence of stroke among selected patients undergoing elective posterior lumbar fusion: a retrospective cohort study

2020 ◽  
Author(s):  
Patrick J Arena ◽  
Jingping Mo ◽  
Charu Sabharwal ◽  
Elizabeth Begier ◽  
Xiaofeng Zhou ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Lumbar Fusion ◽  
Index Hospitalization ◽  
Stroke Incidence ◽  
Posterior Lumbar Fusion ◽  
Post Operation ◽  
History Of

Abstract Background: Although stroke is a rare complication among spinal surgery patients, the recognition of this adverse event is critical given the aging population undergoing surgical procedures. The objective of this study was to estimate the incidence of stroke among selected adults undergoing elective posterior lumbar fusion (PLF) during various post-operative risk windows and among different subgroups.Methods: A retrospective cohort study using a longitudinal electronic healthcare record (EHR) database was conducted from January 1, 2007 to June 30, 2018. Elective PLF, stroke, and select clinical characteristics were defined based on International Classification of Disease codes. Patients aged 18 to 85 years with ≥ 183 days of enrollment in the database prior to undergoing elective PLF were followed from the index date until the occurrence of stroke, death, loss to follow-up, or end of study period, whichever occurred first. The incidence of stroke was estimated in the following risk windows: index hospitalization, ≤ 30 days, ≤ 90 days, ≤ 180 days, and ≤ 365 days post-operationResults: A total of 43,063 patients were eligible for the study. The incidence of stroke following elective PLF was 0.29% (95% confidence interval [CI]: 0.25%, 0.35%) during index hospitalization, 0.44% (95% CI: 0.38%, 0.50%) ≤ 30 days, 0.59% (95% CI: 0.52%, 0.67%) ≤ 90 days, 0.76% (95% CI: 0.68%, 0.85%) ≤ 180 days, and 1.12% (95% CI: 1.03%, 1.23%) ≤ 365 days post-operation. Stratified analyses revealed that older patients had a higher incidence of stroke. Additionally, black patients had higher stroke incidences. Post-operative stroke incidence was higher among patients with a history of type 2 diabetes than among patients without such history; similarly, stroke incidence was higher among patients with a history of stroke compared to patients without such history.Conclusions: The incidence of stroke following elective PLF using an EHR database in this study is slightly higher than that reported in the literature. Our results suggest that stroke risk modification prior to PLF may be important for patients who are older, black, type 2 diabetic, and/or have a history of stroke.

scholarly journals The incidence of stroke among selected patients undergoing elective posterior lumbar fusion: a retrospective cohort study

2020 ◽  
Author(s):  
Patrick J Arena ◽  
Jingping Mo ◽  
Charu Sabharwal ◽  
Elizabeth Begier ◽  
Xiaofeng Zhou ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Lumbar Fusion ◽  
Index Hospitalization ◽  
Stroke Incidence ◽  
Posterior Lumbar Fusion ◽  
Post Operation ◽  
History Of

Abstract Background: Although stroke is a rare complication among spinal surgery patients, the recognition of this adverse event is critical given the aging population undergoing surgical procedures. The objective of this study was to estimate the incidence of stroke among selected adults undergoing elective posterior lumbar fusion (PLF) during post-operative risk windows and among different subgroups.Methods: A retrospective cohort study using a longitudinal electronic healthcare record (EHR) database was conducted from January 1, 2007 to June 30, 2018. Elective PLF, stroke, and select clinical characteristics were defined based on International Classification of Disease codes. Patients aged 18 to 85 years with ≥ 183 days of enrollment in the database prior to undergoing elective PLF were followed from the index date until the occurrence of stroke, death, loss to follow-up, or end of study period, whichever occurred first. Incidence proportions (IPs) and rates (IRs) of stroke were estimated in the following risk windows: index hospitalization, ≤ 30 days, ≤ 90 days, ≤ 180 days, and ≤ 365 days post-operationResults: A total of 43,063 patients were eligible for the study. The IP of stroke following elective PLF ranged from 0.29% (95% confidence interval [CI]: 0.25%, 0.35%) during index hospitalization to 1.12% (95% CI: 1.03%, 1.23%) ≤ 365 days post-operation; the IR of stroke following elective PLF per 1000 person-years decreased consistently from 229.08 (95% CI: 192.38, 272.78) during index hospitalization to 13.68 (95% CI: 12.51, 14.96) ≤ 365 days post-operation. Stratified analyses revealed that older patients had a higher incidence of stroke. Additionally, black patients had higher stroke incidences. Post-operative stroke incidence was higher among patients with a history of type 2 diabetes than among patients without such history.Conclusions: The incidence of stroke following elective PLF using an EHR database in this study is slightly higher than that reported in the literature. Our results suggest that stroke risk modification prior to PLF may be important for patients who are older, black, type 2 diabetic, and/or have a history of stroke.

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