[The impact of health and socioeconomic factors on the incidence of complications in middle ear cholesteatoma in Western Yunnan].

Objective: To explore the health-related and socioeconomic factors affecting the incidence of complications in patients with middle ear cholesteatoma in Western Yunnan. Methods: A retrospective analysis was performed on complete clinical and socioeconomic data of 326 patients with middle ear cholesteatoma confirmed by postoperative pathology at the Department of Otorhinolaryngology, Dali Bai Autonomous Prefecture People's Hospital from January 2014 to January 2024, and the occurrence of complications was recorded. There were 160 males and 166 females, aged 2-81 years, with a mean age of 44 years. General clinical data, socioeconomic factors and medical-seeking conditions were collected. Univariate analyses including independent-sample t-test and χ²-test were used to screen factors correlated with complications. Variables with statistical significance were entered into a binary logistic regression model for multivariate risk-factor analysis to identify the independent influencing factors for complications of middle ear cholesteatoma. Results: Among the 326 patients, complications occurred in 110 cases, with an overall complication rate of 33.74% (110/326). Univariate analysis showed that age, disease duration, health status and medical expense payment method were significantly associated with complications (P<0.05), whereas, gender showed no significant correlation with complications (P>0.05). Multivariate binary logistic regression verified that comorbid chronic underlying diseases such as hypertension and diabetes were independent risk factors for complications (OR>1, P<0.05). Medical expense payment method was an independent protective factor for reducing the risk of complications (OR<1, P<0.05). Conclusions: Comorbid underlying diseases and medical expense payment method are core independent factors influencing the incidence of complications in patients with middle ear cholesteatoma in Western Yunnan. Relevant departments in Western Yunnan should target high-risk patients, focus on medical-insurance coverage, standardized management of underlying diseases, and health-knowledge popularization, so as to reduce the risk of complications of middle ear cholesteatoma and to alleviate the health-economic burden.