Risk Factors of Sensorineural Hearing Loss in Patients With Ischemic Stroke

Abstract

We investigated risk factors of sensorineural hearing loss (SHL) in patients with early stage of ischemic stroke (IS). Our study consisted of 60 patients with IS who were treated at Department of Neurology, Medical University of Gdansk between 2006 and 2007. A multivariate stepwise linear regression was used to identify the risk factors that were related to SHL as measured by pure-tone average (0.5, 1, and 2 kHz), the high-tone average (4, 6, and 8 kHz), the pure-tone middle-tone average (0.5, 1, 2, and 4 kHz), and the overall average (0.5, 1, 2, 4, 6, and 8 kHz). The following factors were included in the analysis: age, sex, smoking habit, addiction to alcohol, presence of tinnitus and vestibular symptoms, arterial hypertension, cardiac ischemic disease, hyperlipidemia, diabetes, number of risk factors, neurologic state at the admission, localization of stroke, cause of stroke, number of ischemic focuses, the side and diameter of ischemic focuses, the result of directional hearing acuity angle test, results of certain laboratory tests, blood morphology parameters, and coagulogram. Values for p less than 0.05 were considered significant. Our analysis suggests the presence of the following risk factors of SHL in patients with IS: 1) older age (>60 yr); 2) male sex; 3) presence of tinnitus; 4) arterial hypertension; 5) lacunar type of stroke; 6) presence of multiple ischemic focuses; 7) presence of bilateral ischemic focuses; 8) changes in blood cell count; and 9) disturbances of agglutination. The highest risk of hearing loss in the group of IS patients occurred at older people, particularly men with tinnitus, lacunar stroke, multiple, bilateral ischemic focuses, and arterial hypertension. A negative statistically significant influence of decreased level of red cells, platelets, and hematocrit value on hearing loss was found. Abnormally lowered levels of activated partial thromboplastin time, activated partial thromboplastin time ratio, prothrombin index, and abnormal lowered level of international normalized ratio statistically impaired hearing.