Impact of Autoimmune Diseases on the Prognosis of Unilateral Sudden Sensorineural Hearing Loss.

Abstract

To evaluate clinical features of unilateral sudden sensorineural hearing loss (SSNHL) in patients with autoimmune disease and identify factors influencing the prognosis of such patients. Retrospective, case-control study. A single tertiary referral center. Patients diagnosed with both unilateral SSNHL and autoimmune disease (n = 46) who were hospitalized between January 2018 and October 2023 were included in the autoimmune disease group. A control group propensity score matched for sex, age, and initial pure-tone average (n = 183) comprised hospitalized patients with unilateral SSNHL but without autoimmune disease. The two groups were compared regarding clinical symptoms, audiological evaluations, vestibular function assessments, laboratory blood test results, and hearing outcomes. Prognostic factors were analyzed using binary logistic regression. Autoimmune disease and non-autoimmune disease groups differed significantly in terms of the monocyte-to-lymphocyte ratio, total bilirubin, and indirect bilirubin (P < .05) levels. Univariate analysis identified significant associations between hearing prognosis and the time from disease onset to treatment and final pure-tone average, monocyte-to-lymphocyte ratio, indirect bilirubin, and high-density lipoprotein levels (P < .05). Multivariate analysis further confirmed that time from disease onset to treatment and monocyte-to-lymphocyte ratio and indirect bilirubin levels were independent prognostic predictors in the autoimmune disease group. Patients with unilateral SSNHL with autoimmune disease exhibited elevated levels of monocyte-to-lymphocyte ratio and reduced total bilirubin and indirect bilirubin levels as compared with those without autoimmune disease. Time from disease onset to treatment, monocyte-to-lymphocyte ratio, and indirect bilirubin levels were strongly associated with prognosis in this patient population.