Fnais Naif, Gomes Tara, Mahoney James, Alissa Sami, Mamdani Muhammad
College of Medicine, King Saud University, Riyadh, Saudi Arabia.
The Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
PLoS One. 2014 May 14;9(5):e97499. doi: 10.1371/journal.pone.0097499. eCollection 2014.
Carpal tunnel release (CTR) is among the most common hand surgeries, although little is known about its pattern. In this study, we aimed to investigate temporal trends, age and gender variation and current practice patterns in CTR surgeries.
We conducted a population-based time series analysis among over 13 million residents of Ontario, who underwent operative management for carpal tunnel syndrome (CTS) from April 1, 1992 to March 31, 2010 using administrative claims data.
The primary analysis revealed a fairly stable procedure rate of approximately 10 patients per 10,000 population per year receiving CTRs without any significant, consistent temporal trend (p = 0.94). Secondary analyses revealed different trends in procedure rates according to age. The annual procedure rate among those age >75 years increased from 22 per 10,000 population at the beginning of the study period to over 26 patients per 10,000 population (p<0.01) by the end of the study period. CTR surgical procedures were approximately two-fold more common among females relative to males (64.9% vs. 35.1 respectively; p<0.01). Lastly, CTR procedures are increasingly being conducted in the outpatient setting while procedures in the inpatient setting have been declining steadily - the proportion of procedures performed in the outpatient setting increased from 13% to over 30% by 2010 (p<0.01).
Overall, CTR surgical-procedures are conducted at a rate of approximately 10 patients per 10,000 population annually with significant variation with respect to age and gender. CTR surgical procedures in ambulatory-care facilities may soon outpace procedure rates in the in-hospital setting.
腕管松解术（CTR）是最常见的手部手术之一，但其手术模式鲜为人知。在本研究中，我们旨在调查CTR手术的时间趋势、年龄和性别差异以及当前的手术模式。
我们利用行政索赔数据，对安大略省超过1300万居民进行了一项基于人群的时间序列分析，这些居民在1992年4月1日至2010年3月31日期间接受了腕管综合征（CTS）的手术治疗。
初步分析显示，每年每10000人口中接受CTR手术的患者数量相当稳定，约为10例，且无任何显著的、持续的时间趋势（p = 0.94）。二次分析显示，根据年龄不同，手术率呈现不同趋势。75岁以上人群的年手术率从研究初期的每10000人口22例增加到研究期末的每10000人口超过26例（p<0.01）。女性接受CTR手术的比例约为男性的两倍（分别为64.9%和35.1%；p<0.01）。最后，CTR手术越来越多地在门诊进行，而住院手术则在稳步下降——到2010年，门诊手术的比例从13%增加到超过30%（p<0.01）。
总体而言，CTR手术的实施率约为每年每10000人口10例，在年龄和性别方面存在显著差异。门诊护理机构的CTR手术率可能很快超过医院环境中的手术率。
