当他们不再前来：小儿小耳畸形患者BCHD依从性的关键因素
When They Stop Coming: Key Factors in Pediatric BCHD Adherence in Microtia Patients.
文献信息
| PMID | 42714262 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Sih-Yu Chan |
| 作者单位 | University of Texas at Austin, Austin, Texas, USA. |
| 期刊 | The Laryngoscope |
| SCI 分区 | Q2 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 分析与小耳畸形及耳道闭锁儿科患者骨导听力设备随访护理依从性相关的人口学和临床因素。
方法： 对三级护理小耳畸形数据库（2015-2025年）中127例患者进行回顾性病历审查。收集的数据包括种族、保险类型、当前年龄、验配年龄、单侧与双侧听力损失、首次随访时间、年度就诊频率和每日数据记录小时数，每项均作为复合依从性评分（1-9）的组成部分和独立变量进行分析。
结果： 多变量分析显示，单侧听力损失是依从性降低的最强预测因素（OR = 4.504，p = 0.034）。年龄较大与依从性降低独立相关；年龄≥11岁的患者依从性差的几率显著高于6岁以下患者（OR = 5.795，p = 0.001）。而7-10岁患者依从性降低的几率为4倍（OR = 4.391，p = 0.003）。与私人保险相比，公共保险或无保险与依从性降低相关（p = 0.009）。验配年龄不显著（p = 0.098）。对每日数据记录小时数的独立分析证实其与依从性层级显著相关（p < 0.001）；在多变量分析中，每日记录少于4小时的患者依从性降低的几率显著更高（OR = 33.39，p = 0.003）。
结论： 单侧听力损失、公共保险或无保险以及年龄较大是儿科患者长期BCHD依从性差的危险因素。通过数据记录测量的每日设备佩戴减少是一个强有力的独立预测因素，应常规监测。
英文摘要
OBJECTIVE: To analyze the demographic and clinical factors associated with adherence to bone conduction hearing device follow-up care in pediatric patients with microtia and aural atresia.
METHODS: Retrospective chart review of 127 patients in a tertiary care microtia database (2015-2025). Data collected included ethnicity, insurance type, current age, fitting age, unilateral versus bilateral hearing loss, time to first follow-up, annual visit frequency, and daily datalogging hours, each analyzed as components of a composite adherence score (1-9) and as independent variables.
RESULTS: Unilateral hearing loss was the strongest predictor of decreased adherence on multivariate analysis (OR = 4.504, p = 0.034). Older age was independently associated with reduced adherence; patients aged ≥ 11 years had significantly higher odds of poor adherence versus those under 6 years (OR = 5.795, p = 0.001). While patients aged 7-10 had 4 times the odds of reduced adherence (OR = 4.391, p = 0.003). Public or no insurance was associated with decreased adherence versus private insurance (p = 0.009). Fitting age was not significant (p = 0.098). Independent analysis of daily datalogging hours confirmed a significant association with adherence tier (p < 0.001); patients logging fewer than 4 h per day had markedly higher odds of decreased adherence on multivariate analysis (OR = 33.39, p = 0.003).
CONCLUSIONS: Unilateral hearing loss, public or no insurance, and older age are risk factors for poor long-term BCHD adherence in pediatric patients. Reduced daily device wear, as measured by datalogging, is a strong independent predictor and should be routinely monitored.