Low Geriatric Nutritional Risk Index Predicts Unfavorable Outcomes in Older Sudden Sensorineural Hearing Loss Patients.

ImportanceSudden sensorineural hearing loss (SSNHL) is associated with metabolic syndrome, central obesity, and albumin level. Malnutrition may adversely affect recovery in older patients with SSNHL, yet its clinical relevance remains underexplored.ObjectiveThis study investigated the associations of the geriatric nutritional risk index (GNRI) with clinical outcomes in older patients (age >65 years) with SSNHL.DesignObservational retrospective study.SettingTertiary academic medical center.ParticipantsA total of 328 patients aged over 65 years who were diagnosed with SSNHL were retrospectively enrolled. Patients were included if they had complete clinical, audiometric, and laboratory data, including serum albumin levels and anthropometrics for GNRI calculation.Intervention/ExposuresThe primary exposure was the GNRI, calculated using body weight, height, and serum albumin. All patients received steroid treatment for SSNHL.Main Outcome MeasuresThe primary outcome was hearing recovery, categorized as favorable or unfavorable based on clinical audiometric improvement.ResultsAmong older patients with SSNHL, 107 (32.62%) and 221 (67.38%) had favorable and unfavorable outcomes, respectively. Vertigo, worse initial level of hearing loss, and low GNRI were mainly associated with unfavorable hearing outcomes in older patients with SSNHL. Furthermore, low GNRI (<99) was linked to unfavorable clinical outcomes (odds ratio [OR] = 1.91, P = .0151). Multivariate logistic regression revealed that vertigo (aOR = 3.45, P = .0002), worse initial level of hearing loss (per 1 unit increase in hearing loss elevates the risk of poor hearing recovery by 2%, P = .0015), and low GNRI (aOR = 1.79, P = .0435) were associated with unfavorable clinical outcomes.ConclusionIn summary, evaluation of nutritional status plays a crucial role in improving clinical outcomes in SSNHL. Moreover, GNRI can predict clinical outcomes in older patients with SSNHL treated with steroids. Older patients with SSNHL who have vertigo, a worse initial level of hearing loss, and low GNRI exhibit unfavorable outcomes.RelevanceGNRI is a simple, accessible marker that can help identify older SSNHL patients at higher risk of poor recovery. Future prospective studies should validate its use as a prognostic tool and explore whether nutritional interventions can improve hearing outcomes.