Christina Jerosch-Herold1, Lee Shepstone2, Julie Houghton1, Edward C F Wilson3, Julian Blake4. 1. School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, United Kingdom. 2. Norwich Medical School, University of East Anglia, Norwich, United Kingdom. 3. Cambridge Centre for Health Services Research, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom. 4. Department of Neurophysiology, Norfolk and Norwich University Hospital, Norwich, United Kingdom.
Abstract
INTRODUCTION: Studies of prognosis for surgery and corticosteroid injection for carpal tunnel syndrome (CTS) have considered only a limited range of explanatory variables for outcome. METHODS: Data were prospectively collected on patient-reported symptoms, physical and psychological functioning, comorbidity, and quality of life at baseline and every 6 months for up to 2 years. Outcomes were patient-rated change over a 6-month period and symptom-severity score at 18 months. RESULTS: In total, 754 patients with CTS completed baseline questionnaires, and 626 (83%) completed follow-up to 18 months. Multivariable modeling identified, independent of symptom severity at outset, higher health utility, fewer comorbidities, and lower anxiety as significant predictors of better outcome from surgery. In patients treated by steroid injection, independent of symptom severity at outset, shorter duration of symptoms and having no prior injection were significant predictors of better outcome. DISCUSSION: These multivariable models of outcome may inform shared decision making about treatment for CTS. Muscle Nerve, 2019.
INTRODUCTION: Studies of prognosis for surgery and corticosteroid injection for carpal tunnel syndrome (CTS) have considered only a limited range of explanatory variables for outcome. METHODS: Data were prospectively collected on patient-reported symptoms, physical and psychological functioning, comorbidity, and quality of life at baseline and every 6 months for up to 2 years. Outcomes were patient-rated change over a 6-month period and symptom-severity score at 18 months. RESULTS: In total, 754 patients with CTS completed baseline questionnaires, and 626 (83%) completed follow-up to 18 months. Multivariable modeling identified, independent of symptom severity at outset, higher health utility, fewer comorbidities, and lower anxiety as significant predictors of better outcome from surgery. In patients treated by steroid injection, independent of symptom severity at outset, shorter duration of symptoms and having no prior injection were significant predictors of better outcome. DISCUSSION: These multivariable models of outcome may inform shared decision making about treatment for CTS. Muscle Nerve, 2019.
Authors: Conrad J Harrison; Luke Geoghegan; Chris J Sidey-Gibbons; Paul H C Stirling; Jane E McEachan; Jeremy N Rodrigues Journal: Plast Reconstr Surg Glob Open Date: 2022-04-18