Dafang Zhang1, Jamie Collins2, Philip Blazar2, Brandon E Earp2. 1. Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA. Electronic address: dzhang9@partners.org. 2. Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
Abstract
PURPOSE: The aim of this study was to determine factors associated with presentation of carpal tunnel syndrome for carpal tunnel release (CTR) in the advanced electrodiagnostic stages. METHODS: We identified 920 patients with preoperative electrodiagnostic studies (EDSs) who underwent CTR at a tertiary-care referral center from July 2008 to June 2013. Patients were divided into 2 groups: those in the advanced electrodiagnostic stage, defined as those with unrecordable nerve potentials on preoperative EDSs (group 1), and those with recordable nerve potentials on preoperative EDSs (group 2). Logistic regression was used to determine factors that were associated with presentation in the advanced stages of the disease. RESULTS: Multivariable regression analysis showed older age (odds ratio [OR] 1.05; 95% confidence interval [95% CI], 1.04-1.07), diabetes mellitus (OR, 1.72; 95% CI, 1.13-2.62), and hypertension (OR, 1.88; 95% CI, 1.25-2.84) to be associated with advanced presentation for CTR. CONCLUSIONS: A 10-year increase in age results in a 1.6-times increase in the odds of advanced presentation. Diabetes mellitus or hypertension independently doubles the odds of advanced presentation. A subset of symptomatic patients with carpal tunnel syndrome may benefit from earlier referral for hand surgery evaluation and earlier CTR. Older patients with diabetes mellitus and hypertension are at increased risk for advanced presentation. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic II.
PURPOSE: The aim of this study was to determine factors associated with presentation of carpal tunnel syndrome for carpal tunnel release (CTR) in the advanced electrodiagnostic stages. METHODS: We identified 920 patients with preoperative electrodiagnostic studies (EDSs) who underwent CTR at a tertiary-care referral center from July 2008 to June 2013. Patients were divided into 2 groups: those in the advanced electrodiagnostic stage, defined as those with unrecordable nerve potentials on preoperative EDSs (group 1), and those with recordable nerve potentials on preoperative EDSs (group 2). Logistic regression was used to determine factors that were associated with presentation in the advanced stages of the disease. RESULTS: Multivariable regression analysis showed older age (odds ratio [OR] 1.05; 95% confidence interval [95% CI], 1.04-1.07), diabetes mellitus (OR, 1.72; 95% CI, 1.13-2.62), and hypertension (OR, 1.88; 95% CI, 1.25-2.84) to be associated with advanced presentation for CTR. CONCLUSIONS: A 10-year increase in age results in a 1.6-times increase in the odds of advanced presentation. Diabetes mellitus or hypertension independently doubles the odds of advanced presentation. A subset of symptomatic patients with carpal tunnel syndrome may benefit from earlier referral for hand surgery evaluation and earlier CTR. Older patients with diabetes mellitus and hypertension are at increased risk for advanced presentation. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic II.
Authors: Mar Hernández-Secorún; Raquel Montaña-Cortés; César Hidalgo-García; Jacobo Rodríguez-Sanz; Jaime Corral-de-Toro; Sofia Monti-Ballano; Sami Hamam-Alcober; José Miguel Tricás-Moreno; María Orosia Lucha-López Journal: Int J Environ Res Public Health Date: 2021-02-28 Impact factor: 3.390