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Open carpal tunnel release and diabetes : A retrospective study using PROMs and national quality registries

Zimmerman, Malin LU ; Eeg-Olofsson, Katarina; Svensson, Ann Marie; Åström, Mikael; Arner, Marianne LU and Dahlin, Lars LU (2019) In BMJ Open 9(9).
Abstract

Objectives 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. Design Retrospective cohort study. Setting 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). Participants We identified 9049 patients (10 770 hands) operated for CTS during the inclusion period (2010-2016). Primary outcome measures 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... (More)

Objectives 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. Design Retrospective cohort study. Setting 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). Participants We identified 9049 patients (10 770 hands) operated for CTS during the inclusion period (2010-2016). Primary outcome measures 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. Results 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. Conclusions 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.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
carpal tunnel syndrome, diabetes, diabetes complications, diabetic retinopathy, glycated hemoglobin A, open carpal tunnel syndrome
in
BMJ Open
volume
9
issue
9
publisher
British Medical Journal Publishing Group
external identifiers
  • scopus:85071739027
ISSN
2044-6055
DOI
10.1136/bmjopen-2019-030179
language
English
LU publication?
yes
id
0541de8e-ced1-4db5-b56e-a4a22d35f244
date added to LUP
2019-09-17 08:43:52
date last changed
2019-10-08 03:57:46
@article{0541de8e-ced1-4db5-b56e-a4a22d35f244,
  abstract     = {<p>Objectives 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. Design Retrospective cohort study. Setting 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). Participants We identified 9049 patients (10 770 hands) operated for CTS during the inclusion period (2010-2016). Primary outcome measures 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. Results 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. Conclusions 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.</p>},
  articleno    = {e030179},
  author       = {Zimmerman, Malin and Eeg-Olofsson, Katarina and Svensson, Ann Marie and Åström, Mikael and Arner, Marianne and Dahlin, Lars},
  issn         = {2044-6055},
  keyword      = {carpal tunnel syndrome,diabetes,diabetes complications,diabetic retinopathy,glycated hemoglobin A,open carpal tunnel syndrome},
  language     = {eng},
  number       = {9},
  publisher    = {British Medical Journal Publishing Group},
  series       = {BMJ Open},
  title        = {Open carpal tunnel release and diabetes : A retrospective study using PROMs and national quality registries},
  url          = {http://dx.doi.org/10.1136/bmjopen-2019-030179},
  volume       = {9},
  year         = {2019},
}