(179) Epidemiology of Chronic Suppurative Otitis Media in the United States

Introduction: The epidemiology of chronic suppurative otitis media (CSOM) has not been well characterized in the US, despite it being a leading cause of morbidity including hearing loss. We aim to addresses this gap by estimating the prevalence, incidence, and describe the demographics for CSOM using a nationwide healthcare claims database.

Methods: A retrospective study over a 10-year (2007-2016) period utilized administrative claims data from the Truven Health MarketScan Research Database. The database (86,999,625 claims with 1,237,192 unique patients) includes health data from the private-sector, Medicare/Medicaid, managed care providers, and EMR providers. Outpatient services data were primarily used for this study. Included patients had a diagnosis of CSOM based on ICD-9-CM codes 382.1, 382.2, 382.3, and 382.4. Prevalence and incidence were estimated by age, gender, and geographic region.

Results: Among patients with CSOM (n=5,071), mean age (SD) was 12.9 (18.6) years, and 2,684 (52.9%) were male. Most patients (n=3,573; 70.5%) were aged 0-10 years. In the United States, the overall prevalence is estimated to be 0.41% (95% confidence interval 0.398%-0.421%) and the overall incidence was 0.045%. CSOM prevalence decreased with age (odds ratio = 0.941, p < 0.001) and is lower in females (odds ratio= 0.895, p-value < 0.001). Prevalence was highest in the Southern (0.18%) and lowest in the Western (0.06%) states. Of significance, CSOM prevalence odds ratio adjusted for geographic region is 0.8346 (p-value < 0.001) in the West Coast and is 0.9198 (p-value < 0.05) in the South. On average, patients had 2.76 provider visits annually for CSOM. Prescription and surgical costs were estimated to determine associated outcomes.

Conclusions: Our results show CSOM prevalence, at 0.41%, is similar to other developed countries. CSOM prevalence was highest in those aged 0-10, in males and in the South. Of note, this prevalence is likely an underestimate given limitations in accurate ICD coding and the exclusion of uninsured patients. Further epidemiological studies are warranted to characterize the impact of CSOM on the US healthcare system.