Risk Factors for Tinnitus in 37,692 Patients Followed in General Practices in Germany

Background: Tinnitus is frequently associated with a major hearing handicap, which has a significant impact on the quality of life of patients. Aims: The goal was to analyze risk factors for tinnitus in patients followed in general practices in Germany. Methods: Patients who had received a first tinnitus diagnosis in one of 928 general practices between January 2014 and December 2017 were included in this study. Controls without a tinnitus diagnosis were matched (1:1) to tinnitus cases by age, sex, index year, and physician. In total, 18,846 patients with tinnitus and 18,846 matched controls without tinnitus were included in the present study. Potential risk factors for tinnitus included in the present study were diseases of the ear, diseases of the upper respiratory tract, mental disorders, diseases of the nervous system, endocrine diseases, diseases of the circulatory system, and hemolytic anemias. A multivariate logistic regression with stepwise selection was used to analyze the association between defined diagnoses and tinnitus. Results: A total of 20 diseases were significantly associated with tinnitus. The five diagnoses displaying the strongest effect were vestibular neuronitis (odds ratio [OR] = 3.29, 95% confidence interval [CI]: 1.56–6.90), Menière's disease (OR = 3.23, 95% CI: 1.78–5.86), Eustachian salpingitis and obstruction (OR = 2.51, 95% CI: 1.72-3.67), presbycusis (OR = 2.27, 95% CI: 1.93-2.67), and otalgia and ear effusion (OR = 1.99, 95% CI: 1.56–2.53). Conclusions: Tinnitus was associated with a wide range of conditions, in particular disorders of the ear. Address correspondence and reprint requests to: Karel Kostev, Ph.D., D.M.Sc., Epidemiology, IQVIA, Darmstädter Landstraße 108, 60598 Frankfurt am Main, Germany; E-mail kkostev@de.imshealth.com Funding: The authors have received no financial support for the research, authorship, and/or publication of this article. Ethic statement: German law allows the use of anonymous electronic medical records for research purposes under certain conditions. According to this legislation, it is not necessary to obtain informed consent from patients or approval from a medical ethics committee for this type of observational study that contains no directly identifiable data. Therefore, no waiver of ethical approval was obtained from an Institutional Review Board or ethics committee. The authors had no access to any identifying information at any moment during the analysis of the data. The authors declare that they have no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Copyright © 2019 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company

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