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Effects of diabetes mellitus on the rate of carpal tunnel release in patients with carpal tunnel syndrome

 Jaeyong Shin  ;  Yong Wook Kim  ;  Sang Chul Lee  ;  Seung Nam Yang  ;  Jee Suk Chang  ;  Seo Yeon Yoon 
 SCIENTIFIC REPORTS, Vol.11(1) : 15858, 2021-08 
Journal Title
Issue Date
Adult ; Aged ; Carpal Tunnel Syndrome / pathology ; Carpal Tunnel Syndrome / surgery* ; Case-Control Studies ; Cohort Studies ; Diabetes Mellitus / physiopathology* ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications / epidemiology* ; Postoperative Complications / etiology ; Postoperative Complications / pathology ; Republic of Korea / epidemiology
The objective of this study was to evaluate the effects of diabetes mellitus (DM) on the rate of carpal tunnel release (CTR) using a large nationwide cohort in Korea and to identify risk factors, including comorbidities and socioeconomic status (SES), associated with CTR. Patients with a primary or secondary diagnosis of carpal tunnel syndrome (CTS; ICD-10 code: G560) were selected and divided into two groups according to the presence of DM. A Cox proportional hazard model was used to assess the rate of CTR between the two groups. To evaluate the influence of demographic factors, comorbidities, and SES on CTR, multivariate Cox proportional hazard regression models were used to adjust for confounding variables. In total, 12,419 patients with CTS were included in the study: 2487 in DM cohort and 9932 in non-DM cohort. DM duration was negatively related with the rate of CTR (HR = 0.89, 95% CI 0.87-0.91) in CTS patients with DM. The rate of CTR was decreased in patients with DM compared to those without DM in the unadjusted model; however, after adjusting for comorbidities, DM had no significant effect on the rate of CTR. Female sex (HR = 1.50, 95% CI 1.36-1.67) correlated with the rate of CTR, and an inverse relationship between the number of comorbidities and CTR was found (p < 0.001) irrespective of DM. Diabetic polyneuropathy (DPN) was not associated with CTR, and we did not find any factors correlating with CTR in DPN patients. We found that CTS patients with more comorbidities or combined with a longer duration of DM were undertreated in real-word practice. Actual outcomes of CTR in CTS patents with various comorbidities should be investigated in future studies for optimal management of CTS.
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1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yong Wook(김용욱) ORCID logo https://orcid.org/0000-0002-5234-2454
Shin, Jae Yong(신재용) ORCID logo https://orcid.org/0000-0002-2955-6382
Lee, Sang Chul(이상철) ORCID logo https://orcid.org/0000-0002-6241-7392
Chang, Jee Suk(장지석) ORCID logo https://orcid.org/0000-0001-7685-3382
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