Hearing loss in Behçet's syndrome: prevalence and associated factors in a nationwide cross-sectional analysis.

BACKGROUND/AIM: The aim of this study was to investigate the prevalence of hearing loss in Behçet's syndrome and its associations with other disease manifestations, comorbidities, and treatment agents. To the best of our knowledge, this is the most comprehensive study to date addressing this issue. MATERIALS AND METHODS: The study was designed as a cross-sectional, nationwide study. The Turkish Ministry of Health National Electronic Database (e-Nabız) was used under the supervision of the Ministry of Health to extract patient data. A nationwide cohort was established from patients who had been assigned an ICD-10 code for BS (M35.2) on at least two occasions, separated by a minimum of 3 months, between 1 January 2016, and 31 December 2022, and were therefore considered to have BS. Data on demographics, comorbidities, major disease manifestations other than mucocutaneous and musculoskeletal involvement, and treatment agents ever used for BS were recorded. Within this cohort, patients who had been assigned an ICD-10 code for hearing loss (H90 or H91 and their subcategories) were classified as BS patients with hearing loss. Demographics, clinical characteristics and treatment history were compared between BS patients with and without hearing loss. RESULTS: A total of 84,240 patients with BS were identified and included in the analysis. Among these patients, 976 were identified as having hearing loss; 487 had sensorineural hearing loss, 71 had conductive hearing loss, 46 had mixed hearing loss, and 464 had unspecified hearing loss. In multivariable analysis, none of the BS-related manifestations remained independently associated with hearing loss. However, male sex, age >50 years at the time of analysis, hypertension, coronary artery disease, chronic kidney disease, malignancy, depression, viral hepatitis, asthma, osteoporosis, and treatment with certolizumab pegol were independently associated with an increased risk of hearing loss. CONCLUSION: In this nationwide study, a prevalence of hearing loss of 1.16% was observed among patients with BS. Our findings suggest that older age and the presence of certain comorbidities, rather than BS-specific manifestations, were associated with hearing loss.