Malignant otitis externa hospitalizations: Analysis of patient characteristics.

OBJECTIVES/HYPOTHESIS: Malignant otitis externa (MOE) is a rare disorder that is not well studied in the inpatient setting. The Nationwide Inpatient Sample (NIS) database was utilized to analyze characteristics and predischarge outcomes of hospitalized MOE patients.

METHODS

MOE hospitalizations were identified in the 2002 to 2013 NIS. Patient demographics, length of hospital stay, hospital charges, concomitant diagnoses, treatment-related procedures, complications, and in-hospital mortality rates were examined, with comparisons made among age cohorts and between diabetes mellitus (DM) and non-DM groups.

RESULTS

A total of 8,300 cases of inpatient MOE were identified, with elderly DM patients compromising 22.7% of cases. Compared to adults, elderly patients had more inpatient procedures, longer hospitalizations (6.0 vs. 4.3 days), higher hospital charges ($26,712 vs. $19,047) (all P < 0.001), greater odds of in-hospital complications, and in-hospital mortality (odds ratio 14.435, 95% confidence interval 5.313-39.220). Adult/elderly patients with DM had more comorbidities, longer hospital stays (5.5 vs. 4.0 days), and higher hospital charges ($25,118 vs. $17,039) (all P < 0.001) than non-DM patients. However, DM was not associated with greater in-hospital mortality rates (0.6% vs. 0.5%; P = 0.640). Compared to the adult/elderly cohort, pediatric patients had higher rates of nonelective admissions (19.8% vs. 14.5%), shorter hospital stays (2.9 vs. 4.9 days), and lower hospital charges ($8,876 vs. $21,672) (all P < 0.05).

CONCLUSION

Elderly diabetic patients made up a smaller fraction of hospitalized MOE cases than anticipated. Elderly patients had greater in-hospital complications and mortality. Diabetes mellitus in adult/elderly patients was not associated with increased mortality. Pediatric patients fared well with low complications rates and no instances of in-hospital mortality.

LEVEL OF EVIDENCE: 2C. Laryngoscope, 127:2328-2336, 2017.