Emory University School of Medicine ATLANTA, Georgia
Educational Objective: At the conclusion of this presentation, the participants should be able to understand the impact of race and socioeconomic status on delayed sensorineural hearing loss diagnosis and cochlear implantation.
Objectives: To determine whether certain pediatric populations are at risk for delayed cochlear implantation.
Study Design: Retrospective study.
Methods: Demographic data was collected for pediatric patients who underwent cochlear implantation between January 1, 2013, and September 1, 2021. Dates of diagnosis of hearing loss by auditory brainstem response, radiological imaging, surgical consultation with an otolaryngologist and implantation were also collected.
Results: 145 pediatric patients underwent cochlear implantation. 57.2% (83) identified as White, 32.4 % (47) as Black, and 5.8% (9) as Asian. The mean age at diagnosis and implantation was 2.36 (┬▒ 3.19) years and 4.24 (┬▒ 4.25) years, respectively. Black patients were 0.61 (┬▒ 0.58) years older than White patients at the time of diagnosis (p=0.046; CI= -0.54 -1.77). Among families with median household income (MHI) above our state's MHI, Black patients were 0.98 years (┬▒ 0.67) years older than White patients at time of diagnosis (p=0.008; CI: -0.35-2.31). Overall, White patients took 0.52 (┬▒ 0.44) years longer to progress from diagnosis to implantation than Black patients (p=0.044; CI= -0.34-1.39). Among families with MHI above our state's MHI, White patients took 1.37 years longer to progress from diagnosis to implantation than Black patients (p=0.043; CI: -0.49-3.24).
Conclusions: Black pediatric patients, especially those of lower socioeconomic status (SES) are at risk of delayed diagnosis of sensorineural hearing loss. In contrast, White pediatric patients, particularly those of higher SES, take longer to progress from diagnosis to implantation. Given the impact of early diagnosis and treatment, it is important identify patients at risk for delayed intervention.