gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Is Carpal Tunnel Syndrome (CTS) two different diseases? A Joint Analysis of 2 Longitudinal Cohort Studies from USA and England Totalling 935,000 Cases

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  • presenting/speaker Jennifer Lane - University of Oxford, NDORMS, Botnar Research Centre, Oxford, United Kingdom
  • Richard Craig - University of Oxford, NDORMS, Botnar Research Centre, Oxford, United Kingdom
  • Gopal Lalchandani - University of California, San Fransisco, Institute of Orthopaedics, San Fransisco, United States
  • Daniel Prieto-Alhambra - University of Oxford, NDORMS, Botnar Research Centre, Oxford, United Kingdom
  • Jane Green - University of Oxford, Nuffield Department of Population Health, Oxford, United Kingdom
  • Paymon Rahgozar - University of California, San Francisco, Department of Plastic and Reconstructive Surgery, San Francisco, United States
  • Igor Immerman - University of California, San Fransisco, Institute of Orthopaedics, San Fransisco, United States
  • Dominic Furniss - University of Oxford, NDORMS, Botnar Research Centre, Oxford, United Kingdom

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-557

doi: 10.3205/19ifssh0664, urn:nbn:de:0183-19ifssh06649

Published: February 6, 2020

© 2020 Lane et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: The aim of this study was to use routinely collected real world data to identify the incidence of carpal tunnel release surgery (CTR) in the US and England, and to compare the demographics of patients undergoing surgery in each country.

Methods: For English data, OPCS codes prospectively collected as part of routine care were used to identify CTRs from April 1998- 2017. For US data, CPT codes were used to identify CTRs in the Humana claims database (PearlDiver Inc, Colorado Springs) from January 2007- December 2016. Patients were followed up until death or the end of the study period. Disease status was defined by ICD codes. Charlson comorbidity index (CCI) was used as an overall marker of comorbidity.

Results: 855, 832 procedures were found in English data; 68% of patients were female. A significantly higher incidence was seen in women, especially those aged 45-60. A second peak in incidence was seen in the over 65's irrespective of gender. Mean CCI was 1.6 (SD2.41); a past medical history of diabetes mellitus was present in 5.8%; obesity in 2.56%, hypothyroidism in 2.43%; rheumatoid arthritis in 0.13%.

80,037 procedures were included from US data; 60% patients were female. 2 peaks in incidence were found; a peak in women aged 45-60, and a peak in both genders from 60-80 years of age. Mean CCI was 2.0 (SD2.51); a past medical history of diabetes mellitus was present in 1.6% of patients; obesity in 0.7%; hypothyroidism in 0.9% and rheumatoid arthritis in 4.8%.

Conclusions: This large study of real world data suggests that there are two differing aetiologies for CTS: hormonal changes associated with menopause in women, and idiopathic CTS, mainly manifesting in older age groups. These trends were seen irrespective of a public or private healthcare system.