{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:01:38Z","timestamp":1786118498477,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the association of frailty with post\u2010cochlear implant (CI) admission, morbidity, and CI\u2010aided word recognition outcomes in veterans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Single\u2010institution tertiary care Veterans Health Administration (VHA) hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Veterans who underwent cochlear implantation between 1998 to 2024 were included. The Modified 5\u2010Item Frailty Index (mFI\u20105) score was used to characterize preoperative frailty. Outcomes of interest were admission from post\u2010anesthesia care unit (PACU), relative risk (RR) of admission among frail patients, and relationship between frailty and post\u2010CI word recognition score (WRS). Ordinal data were analyzed via logistic regression and Chi square tests; a multivariate linear regression was used to assess nominal data. Significance was set at\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ninety\u2010one patients (median age 71 years, range 35\u201092 years) resulted in 41 (39.4%) admissions out of 104 surgical encounters. Admission rate initially increased from 2016 to 2020 (48.9%), then decreased (29%) in 2021. Forty\u2010two (46%) patients met criteria as being frail, while 26 (28.6%) were prefrail. While frail patients were more readily admitted (43% vs 36%; RR 1.15) and had higher rates of dizziness (20% vs 15%; RR 1.23) when compared to the combined cohort of nonfrail and prefrail patients, these relationships were not significant. Preoperative frailty was significantly negatively associated with post\u2010CI WRS at 6\u2010 and 12\u2010month post\u2010CI in a multivariate analysis including patient age (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The prevalence of frailty is high among veterans undergoing cochlear implantation. Patient frailty is significantly associated with post\u2010CI speech recognition but did not appear to impact likelihood of admission or complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70140","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T07:31:55Z","timestamp":1770017515000},"page":"825-832","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["How does Frailty Impact Peri\u2010Operative and Speech Recognition Outcomes for Cochlear Implants in Veterans?"],"prefix":"10.1002","volume":"174","author":[{"given":"Kaitlyn A.","family":"Brooks","sequence":"first","affiliation":[{"name":"Bobby R. Alford Department of Otolaryngology\u2013Head and Neck Surgery Baylor College of Medicine Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin D.","family":"Lovin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Virginia Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex D.","family":"Sweeney","sequence":"additional","affiliation":[{"name":"Bobby R. Alford Department of Otolaryngology\u2013Head and Neck Surgery Baylor College of Medicine Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela S.","family":"Peng","sequence":"additional","affiliation":[{"name":"Bobby R. Alford Department of Otolaryngology\u2013Head and Neck Surgery Baylor College of Medicine Houston Texas USA"},{"name":"Otolaryngology\u2010Head and Neck Surgery Section Michael E. DeBakey Veterans Affairs Medical Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9015-4895","authenticated-orcid":false,"given":"Nathan R.","family":"Lindquist","sequence":"additional","affiliation":[{"name":"Bobby R. Alford Department of Otolaryngology\u2013Head and Neck Surgery Baylor College of Medicine Houston Texas USA"},{"name":"Otolaryngology\u2010Head and Neck Surgery Section Michael E. DeBakey Veterans Affairs Medical Center Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,1]]},"reference":[{"key":"e_1_2_8_2_1","article-title":"Focus on Veterans Health Administration Patient Experience and Health Care Quality","author":"National Veteran Health Equity Report 2021","year":"2022","journal-title":"VHA Office of Health Equity 2022 September"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/epirev\/mxu005"},{"issue":"28","key":"e_1_2_8_4_1","first-page":"955","article-title":"Severe hearing impairment among military veterans\u2010United States, 2010","volume":"60","author":"Centers for Disease Control and Prevention","year":"2011","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/oto2.53"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2010.362"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.13649"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cub.2014.06.053"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2015.07.009"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26738"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2019.0055"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-023-04642-2"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.896869"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003933"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/2473974X211044084"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25055"},{"issue":"1","key":"e_1_2_8_17_1","first-page":"1","article-title":"Challenges of modern medicine\u2014geriatric otolaryngology or the advantages of cooperation between an otolaryngologist and a geriatrician","volume":"73","author":"Skalska A","year":"2018","journal-title":"Otolaryngologia polska = Polish Otolaryngol"},{"key":"e_1_2_8_18_1","first-page":"1","article-title":"Multiple chronic conditions among veterans and nonveterans: United States, 2015\u20102018","volume":"153","author":"Boersma P","year":"2021","journal-title":"Natl Health Stat Rep"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdab149"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/gly232"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16060949"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2301292"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2010.01.028"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.101271"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-016-0329-8"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.14336\/AD.2019.1024"},{"issue":"1","key":"e_1_2_8_27_1","article-title":"Association between patient frailty and postoperative mortality across multiple noncardiac surgical specialties","volume":"156","author":"George EL","year":"2021","journal-title":"JAMA Surg"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2018.12.036"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2019.01.015"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003717"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000004389"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003704"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1159\/000363214"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/ONO.0000000000000058"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/ONO.0000000000000037"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2013.01.021"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-016-5253-7"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2017.11.005"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.70140","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ohn.70140","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.70140","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T16:03:02Z","timestamp":1786032182000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.70140"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,1]]},"references-count":37,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1002\/ohn.70140"],"URL":"https:\/\/doi.org\/10.1002\/ohn.70140","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,1]]},"assertion":[{"value":"2025-07-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}