Frontiers in neurology · 2025
Identifying psychological and clinical risk factors for moderate-to-severe tinnitus in older patients with hearing loss: a multivariable prediction model.
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Zhang Chenguang, Wang Yicong, Zhao Chunlong, Xue Rou, Hu Chenghao, Guo Bin
Аннотация
OBJECTIVE: To develop and validate a clinical prediction model for moderate-to-severe tinnitus (THI ≥ 38) in patients with hearing loss and to identify the key psychological and clinical factors associated with its risk.
METHODS: This retrospective single-centre study included 301 patients with hearing loss who visited Qinghai University Affiliated Hospital between August 2024 and May 2025. The cohort was randomly divided into a training set (n = 210) and a validation set (n = 91) in a 7:3 ratio. Moderate-to-severe tinnitus served as the outcome of interest. Psychological and clinical risk factors were initially screened using univariate logistic regression, and variables with p < 0.05 were subsequently included in a multivariable logistic regression model.
RESULTS: The final multivariable model identified five independent psychological and clinical risk factors for moderate-to-severe tinnitus: older age (OR = 2.415), hypertension (OR = 2.120), poor sleep quality (OR = 2.821), anxiety (OR = 1.967), and severe hearing loss (OR = 3.452). The model demonstrated good discriminative performance, with an AUC of 0.734 in the training set and 0.760 in the validation set.
CONCLUSION: In patients with hearing loss, psychological and clinical risk factors-including poor sleep quality, anxiety, hypertension, and severe hearing loss-were significantly associated with moderate-to-severe tinnitus. These findings underscore the need for integrated management strategies that address both psychological and clinical components of tinnitus risk.
METHODS: This retrospective single-centre study included 301 patients with hearing loss who visited Qinghai University Affiliated Hospital between August 2024 and May 2025. The cohort was randomly divided into a training set (n = 210) and a validation set (n = 91) in a 7:3 ratio. Moderate-to-severe tinnitus served as the outcome of interest. Psychological and clinical risk factors were initially screened using univariate logistic regression, and variables with p < 0.05 were subsequently included in a multivariable logistic regression model.
RESULTS: The final multivariable model identified five independent psychological and clinical risk factors for moderate-to-severe tinnitus: older age (OR = 2.415), hypertension (OR = 2.120), poor sleep quality (OR = 2.821), anxiety (OR = 1.967), and severe hearing loss (OR = 3.452). The model demonstrated good discriminative performance, with an AUC of 0.734 in the training set and 0.760 in the validation set.
CONCLUSION: In patients with hearing loss, psychological and clinical risk factors-including poor sleep quality, anxiety, hypertension, and severe hearing loss-were significantly associated with moderate-to-severe tinnitus. These findings underscore the need for integrated management strategies that address both psychological and clinical components of tinnitus risk.