A prognostic model for the patient‐reported outcome of surgical treatment of carpal tunnel syndrome

Abstract

A multivariate model partially predicts the outcome of carpal tunnel surgery, aids decision making, and helps to manage patient expectations. Muscle Nerve, 2018.

Prognostic factors for response to treatment by corticosteroid injection or surgery in carpal tunnel syndrome (palms study): A prospective multicenter cohort study

“…Conversely, greater functional impairment, presence of diabetes and hypertension, and having surgery on the dominant hand were associated with poorer outcome. We did not find that diabetes was an independent predictor; however, overall lower comorbidity score was when using the same GROC cutoff for classifying success as that used by Bowman et al …”

“…Two very recently published studies have examined predictors of outcome from surgery for CTS . Jansen et al .…”

“…A study by Bowman et al . based on 3,332 surgically treated patients applied both logistic regression and artificial neural network analysis to a total of 87 candidate variables; however, several pertained to individual questions within the same questionnaire, increasing the risk of overfitting from collinearity in the regression model .…”

“…Both the derivation cohort and subsequent validation cohort revealed that those with moderately severe nerve conduction abnormalities, female gender, nocturnal waking, family history of CTS, and a good response to corticosteroid injection were predictors for surgical success. Outcome was modeled by using the same GROC as our study, although Bowman and colleagues used “much better” or “cured” as criteria for success. Conversely, greater functional impairment, presence of diabetes and hypertension, and having surgery on the dominant hand were associated with poorer outcome.…”

“…In patients treated by steroid injection, independent of symptom severity at outset, shorter duration of symptoms and having no prior injection were significant predictors of better outcome. Discussion: These multivariable models of outcome may inform shared decision making about treatment for CTS.Muscle Nerve 60: [32][33][34][35][36][37][38][39][40] 2019 Carpal tunnel syndrome (CTS), the most common Additional supporting information may be found in the online version of this article.…”