# How does Frailty Impact Peri‐Operative and Speech Recognition Outcomes for Cochlear Implants in Veterans?

## TL;DR

This study examines how frailty affects hospital admissions and speech recognition outcomes in veterans who receive cochlear implants.

## Contribution

The study identifies a significant negative association between preoperative frailty and post-CI speech recognition in veterans.

## Key findings

- Frailty was significantly associated with lower post-CI word recognition scores at 6 and 12 months.
- Frail patients had a higher, though not statistically significant, admission rate and dizziness compared to nonfrail patients.
- The prevalence of frailty among veterans undergoing cochlear implantation was 46%.

## Abstract

To investigate the association of frailty with post‐cochlear implant (CI) admission, morbidity, and CI‐aided word recognition outcomes in veterans.

Retrospective cohort.

Single‐institution tertiary care Veterans Health Administration (VHA) hospital.

Veterans who underwent cochlear implantation between 1998 to 2024 were included. The Modified 5‐Item Frailty Index (mFI‐5) score was used to characterize preoperative frailty. Outcomes of interest were admission from post‐anesthesia care unit (PACU), relative risk (RR) of admission among frail patients, and relationship between frailty and post‐CI word recognition score (WRS). Ordinal data were analyzed via logistic regression and Chi square tests; a multivariate linear regression was used to assess nominal data. Significance was set at P < .05.

Ninety‐one patients (median age 71 years, range 35‐92 years) resulted in 41 (39.4%) admissions out of 104 surgical encounters. Admission rate initially increased from 2016 to 2020 (48.9%), then decreased (29%) in 2021. Forty‐two (46%) patients met criteria as being frail, while 26 (28.6%) were prefrail. While frail patients were more readily admitted (43% vs 36%; RR 1.15) and had higher rates of dizziness (20% vs 15%; RR 1.23) when compared to the combined cohort of nonfrail and prefrail patients, these relationships were not significant. Preoperative frailty was significantly negatively associated with post‐CI WRS at 6‐ and 12‐month post‐CI in a multivariate analysis including patient age (P < .05).

The prevalence of frailty is high among veterans undergoing cochlear implantation. Patient frailty is significantly associated with post‐CI speech recognition but did not appear to impact likelihood of admission or complications.