Artikel
Socioeconomic Factors predicting Outcome after Open Carpal Tunnel Release
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Autoren
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Malin Zimmerman
- Department of Translational Medicine - Hand Surgery, Lund University, Skåne University Hospital, Malmö, Sweden
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Erika Nyman
- Department of Clinical and Experimental Medicine, Department of Hand Surgery, Plastic Surgery and Burns, Linköping, Sweden
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Lars B. Dahlin
- Department of Translational Medicine - Hand Surgery, Lund University, Skåne University Hospital, Malmö, Sweden
| Veröffentlicht: | 6. Februar 2020 |
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Gliederung
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Objectives/Interrogation: We aimed to investigate the influence of socioeconomic factors, such as, education level, employment status, marital status, being foreign born and income, on the outcome after open carpal tunnel release (OCTR) for primary carpal tunnel syndrome (CTS).
Methods: Data from the National Quality Register for Hand Surgery Procedures (HAKIR) were combined with data from Statistics Sweden (SCB) to evaluate OCTRs performed 2010 - 2016. QuickDASH (Disabilities of Arm, Shoulder and Hand) questionnaires were filled out by the patients preoperatively and at three and 12 months postoperatively. Each treated hand was considered a separate statistical entity. Kruskal-Wallis, with post-hoc Bonferroni correction, or Chi2 were used to compare groups. In the linear regression analysis, all calculations were adjusted for age at surgery and gender.
Results and Conclusions: A total of 10770 OCTRs were performed during the study period. The regression analysis showed that patients with education from upper secondary school scored on average 6 (95% CI 3-8; p<0.0001) points lower in the 12 months postoperative QuickDASH than patients who had only gone to elementary school. Patients with higher education scored on average 13 (95% CI 10-15; p<0.0001) points lower on the 12 months postoperative QuickDASH than patients who had only gone to elementary school. Patients who had employment scored on average 13 (95% CI 10-15) points lower on the 12 months postoperative QuickDASH score than patients without employment (p<0.0001). Patients who were born outside of Sweden scored on average 13 (95% CI 10-16) points higher on the 12 months postoperative QuickDASH than patients who were born in Sweden (p<0.0001). Widowed patients scored on average 6 (95% CI 2-11; p=0.007) points higher in the 12 months postoperative QuickDASH than patients who were not married. Patients with higher income had lower QuickDASH scores at 12 months. Relative change in QuickDASH between 0 and 12 months postoperatively did not differ between any of the groups, except between unemployed (median 23 [IQR 9-39]) and employed (27 [14-43]; p=0.004).
We conclude that lower education levels, being a widow, low income and immigrant status are associated with more persisting symptoms 12 months after OCTR for CTS, but these factors do not affect the relative improvement in QuickDASH. However, unemployment is associated with a smaller improvement in QuickDASH scores.
