Incidence of Surgically Treated Carpal Tunnel Syndrome

Abstract

Introduction: Most studies about surgical treatment of carpal tunnel syndrome (CTS) focus on specific population subgroups, worker’s compensation patients, or specific types of surgical treatment. There are no general population studies about epidemiological characterization of surgically treated patients with CTS. Factors such as gender, age, and health insurance status may influence the rate of surgical treatment of CTS. Purpose: Evaluate the influence of epidemiological factors such as gender, age, and health insurance status in the rate of CTS surgery in a mixed health care system. Materials and Methods: Nationwide transversal study of total surgically treated patients with CTS in Chile during 2012. The rate of CTS surgeries was estimated using data collected from Chile’s National Hospital Discharge Records, Public and Private Health Care Systems’ yearly reports on population coverage. Chile’s mixed health care system has a distribution of its population of 81% public, 12.9% private, and 6.1% other insurance. Inclusion criteria: Surgical treatment of CTS (ICD-10 International Statistical Classification of Diseases and Related Health Problems diagnosis G560), age older than 20 years. We analyzed the influence of epidemiological factors such as age, gender, and health insurance status on the rate of CTS surgery. The rate of CTS surgeries was estimated per 1000 habitants in each groups, with their confidence intervals (CI) of 95%. Results: National rate of surgical CTS in patients over 20 years during 2012 was of 0.191 (95% CI, 0.184-0.199). Gender distribution showed higher rate of surgeries in female patients, 0.302 (95% CI, 0.289-0.316), compared with males, 0.077 (95% CI, 0.070-0.084). The age distribution of female patients shows a higher rate of surgeries in the 50- to 59-year group, 0.671 (95% CI, 0.622-0.721). Male patients have a later surgical peak in the 60- to 69-year group, 0.126 (95% CI, 0.098-0.154). The rate of surgical CTS is lower in the public health care system, 0.123 (95% CI, 0.116-0.130), than private insurance, 0.406 (95% CI, 0.379-0.433). The gender distribution was similar in both groups. Conclusions: Health insurance status is the most important factor in the rate of surgical CTS. The access to surgical treatment is 3.3 times higher in private insurance than public system. Gender and age show a higher rate of surgery in female patients in the 50- to 59-year group. This distribution is not influenced by insurance status. National rates of surgical CTS are comparable with reports from the literature. These new data can help understand the population’s behavior and plan resources distribution. It also shows the breach that still has to be covered by the public health care system in terms of surgical treatment of CTS.