Author(s)
Jeffrey L. Black, MBA
Taylor J. VanWagenen, BS
Joehassin Cordero, MD, FACS
John Garza, PhD
Affiliation(s)
Texas Tech University Health Sciences Center School of Medicine
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to describe statewide patterns of care and outcomes in necrotizing (malignant) otitis externa (NOE) and compare ICU use and resource utilization by diabetes status.
Objectives: Summarize demographics, comorbidities, interventions, and short-term outcomes in hospitalized NOE and compare diabetic vs nondiabetic profiles.
Study Design: Retrospective, population-based cohort study.
Methods: We identified statewide acute-care hospitalizations with NOE (ICD-10-CM H60.2X) during 2016-2024. After excluding ineligible facilities and admissions, the cohort included 1,481 hospitalizations across 210 hospitals. Primary outcomes were ICU utilization, length of stay (LOS), discharge disposition, and in-hospital mortality. Secondary descriptors included central venous access, mastoidectomy, hyperbaric oxygen therapy, and invasive ventilation. Groups differences were assessed using Fisher's exact test and the t test.
Results: Patients were 52.9% male; 39.8% were older than 65 years. ICU care occurred in 22.8%; in-hospital mortality 1.4%. Comorbidities were frequent: diabetes type 2 61.0%, hypertension 37.8%, chronic kidney disease 30.6%. Procedures included central venous access 16.0% and mastoidectomy 1.1%; Compared with no diabetes, patients with diabetes were older and showed greater resource use: ICU 25.0% vs 18.9% (p = 0.008), central line 18.8% vs 11.0% (p = 0.0001); LOS was longer (7.4 vs 6.4 days; p = 0.083). Mortality was similar (1.4% vs 1.3%).
Conclusions: In a statewide cohort, NOE predominantly affected older adults and individuals with type 2 diabetes. ICU care was common, while in-hospital mortality remaining low. Diabetes was associated with higher ICU utilization and procedure rates, informing triage and counseling for NOE.