Open carpal tunnel release and diabetes: a retrospective study using PROMs and national quality registries.
Adult
Aged
Carpal Tunnel Syndrome
/ surgery
Diabetes Mellitus, Type 1
/ complications
Diabetes Mellitus, Type 2
/ complications
Diabetic Retinopathy
/ complications
Female
Humans
Male
Middle Aged
Patient Reported Outcome Measures
Postoperative Period
Preoperative Period
Registries
Retrospective Studies
Time Factors
carpal tunnel syndrome
diabetes
diabetes complications
diabetic retinopathy
glycated hemoglobin A
open carpal tunnel syndrome
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
04 09 2019
04 09 2019
Historique:
entrez:
7
9
2019
pubmed:
7
9
2019
medline:
2
10
2020
Statut:
epublish
Résumé
To study patient-reported outcome after open carpal tunnel release (OCTR) for carpal tunnel syndrome (CTS) in patients with or without diabetes using national healthcare quality registries. Retrospective cohort study. Data from the Swedish National Quality Registry for Hand Surgery (HAKIR; www.hakir.se) were linked to data from the Swedish National Diabetes Register (NDR; www.ndr.nu). We identified 9049 patients (10 770 hands) operated for CTS during the inclusion period (2010-2016). Patient-reported outcome measures were analysed before surgery and at 3 and 12 months postoperatively using the QuickDASH as well as the HAKIR questionnaire with eight questions on hand symptoms and disability. Patients with diabetes (n=1508; 14%) scored higher in the QuickDASH both preoperatively and postoperatively than patients without diabetes, but the total score change between preoperative and postoperative QuickDASH was equal between patients with and without diabetes. The results did not differ between patients with type 1 or type 2 diabetes. Patients with diabetic retinopathy scored higher in QuickDASH at 3 months postoperatively than patients with diabetes without retinopathy. In the regression analysis, diabetes was associated with more residual symptoms at 3 and 12 months postoperatively. Patients with diabetes experience more symptoms both before and after OCTR, but can expect the same relative improvement from surgery as patients without diabetes . Patients with retinopathy, as a proxy for neuropathy, may need longer time for symptoms to resolve after OCTR. Smoking, older age, higher HbA1c levels and receiving a diabetes diagnosis after surgery were associated with more residual symptoms following OCTR.
Identifiants
pubmed: 31488486
pii: bmjopen-2019-030179
doi: 10.1136/bmjopen-2019-030179
pmc: PMC6731852
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e030179Informations de copyright
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Health Inf Manag. 1997 Mar-May;27(1):31-8
pubmed: 10169442
Acta Neurol Scand. 2002 Sep;106(3):168-72
pubmed: 12174177
Neurology. 1961 Apr;11(4)Pt 1:275-84
pubmed: 13773672
J Hand Surg Br. 2004 Apr;29(2):159-64
pubmed: 15010164
J Hand Surg Br. 2004 Aug;29(4):315-20
pubmed: 15234492
J Neurol Neurosurg Psychiatry. 2007 Jun;78(6):635-7
pubmed: 17056628
Int Orthop. 1991;15(4):325-9
pubmed: 1725676
J Diabetes Complications. 2008 Mar-Apr;22(2):83-7
pubmed: 18280437
J Diabetes Complications. 2009 Jan-Feb;23(1):32-9
pubmed: 18413154
BMC Med Res Methodol. 2008 Oct 30;8:70
pubmed: 18973665
J Diabetes Complications. 2010 May-Jun;24(3):154-62
pubmed: 19217319
J Hand Surg Am. 2009 Sep;34(7):1177-87
pubmed: 19556077
Acta Neuropathol. 2009 Dec;118(6):785-91
pubmed: 19641929
J Hand Surg Am. 2010 Apr;35(4):668-77
pubmed: 20223605
J Neurol Neurosurg Psychiatry. 1946 Oct;9(4):113-8
pubmed: 20241669
ANZ J Surg. 2010 Jan;80(1-2):50-4
pubmed: 20575880
Exp Neurol. 2011 Oct;231(2):199-206
pubmed: 21683699
Lancet. 2011 Jul 9;378(9786):140-6
pubmed: 21705065
J Bone Joint Surg Br. 2012 Jun;94(6):811-4
pubmed: 22628597
J Hand Surg Eur Vol. 2013 Jun;38(5):485-8
pubmed: 23221178
J Clin Endocrinol Metab. 2013 Feb;98(2):466-73
pubmed: 23316085
Acta Orthop Belg. 2013 Aug;79(4):381-5
pubmed: 24205766
Diabetes Care. 2014 Jul;37(7):1863-9
pubmed: 24722493
Diabetologia. 2014 Aug;57(8):1711-9
pubmed: 24865616
BMC Neurosci. 2014 Sep 13;15:107
pubmed: 25216784
J Hand Surg Am. 2014 Nov;39(11):2175-80
pubmed: 25218142
J Hand Surg Eur Vol. 2015 Nov;40(9):900-12
pubmed: 25320122
Diabetologia. 2015 Mar;58(3):625-32
pubmed: 25523623
Diabetes Res Clin Pract. 2014 Dec;106 Suppl 2:S291-4
pubmed: 25550056
Br J Ophthalmol. 2016 Jan;100(1):9-14
pubmed: 25677672
Lancet Diabetes Endocrinol. 2015 Aug;3(8):653-63
pubmed: 26184671
J Hand Ther. 2016 Jan-Mar;29(1):81-8; quiz 88
pubmed: 26601561
J Plast Surg Hand Surg. 2017 Jun;51(3):165-171
pubmed: 27467092
World J Diabetes. 2016 Sep 15;7(17):342-53
pubmed: 27660694
Acta Physiol Scand. 1989 May;136(1):97-105
pubmed: 2773666
J Plast Surg Hand Surg. 2017 Oct;51(5):329-335
pubmed: 27957868
Muscle Nerve. 2017 Dec;56(6):E59-E64
pubmed: 28241376
Hand (N Y). 2017 Apr 1;:1558944717703739
pubmed: 28443704
EFORT Open Rev. 2017 Mar 13;1(4):100-106
pubmed: 28461935
Brain Behav. 2017 Jul 12;7(8):e00763
pubmed: 28828222
J Hand Surg Am. 2018 Mar;43(3):214-219
pubmed: 29054352
J Diabetes Complications. 2018 Apr;32(4):393-399
pubmed: 29478814
Acta Ophthalmol. 2018 Nov;96(7):e804-e810
pubmed: 29504257
J Hand Surg Am. 2018 Dec;43(12):1098-1106.e1
pubmed: 29945840
J Hand Surg Am. 1995 Jan;20(1):109-14
pubmed: 7722249
N Engl J Med. 1995 Jul 13;333(2):89-94
pubmed: 7777034