Wake Forest Baptist Medical Center, Winston-Salem, NC, USA.
Hand (N Y). 2022 Sep;17(5):993-998. doi: 10.1177/1558944720988102. Epub 2021 Jan 19.
Carpal tunnel syndrome (CTS), trigger finger (TF), and De Quervain tenosynovitis (DQ) are 3 common pathologies of the hand often treated with relatively simple surgical procedures. However, outcomes from these procedures can be compromised by postoperative complications. The aim of this study was to evaluate the association between diabetes, tobacco use, and obesity and the incidence of postoperative complications.
We reviewed 597 patients treated surgically for CTS, TF, or DQ from 2010 to 2015. We used bivariate and multivariate analyses to assess independent associations between diabetes, tobacco use, obesity, and surgical complications and compared the incidences with healthier patients without these comorbidities. We also looked at patients with overlapping diagnoses of these comorbidities.
Bivariate analysis showed that patients with diabetes and smokers were more likely to have a surgical complication. Multivariate analysis showed diabetes and tobacco use as independent predictors of complications. The disease states or combinations placing patients at the highest risk of a postoperative complication were the diabetic-smoker-obese, diabetic-smoker, diabetic-obese, diabetic, and smoker-obese groups. The diabetic-smoker-obese patient population had a 42.02% predicted rate of postoperative complications.
Diabetes and tobacco use are independent risk factors for complications after operative treatment of CTS, TF, and DQ. Obesity when coexisting with diabetes mellitus (DM) and/or tobacco use increased the risk of complications. When the 3 patient factors evaluated, DM, obesity, and tobacco use, were present, the rate of complications was 42.02%. Careful assessment and discussion should occur before proceeding with operative treatment for simple hand conditions in patients with the risk factors studied.
腕管综合征（CTS）、扳机指（TF）和 De Quervain 腱鞘炎（DQ）是手部 3 种常见的病理情况，通常采用相对简单的手术治疗。然而，这些手术的结果可能因术后并发症而受到影响。本研究旨在评估糖尿病、吸烟和肥胖与术后并发症发生率之间的关系。
我们回顾了 2010 年至 2015 年间接受手术治疗的 597 例 CTS、TF 或 DQ 患者。我们使用双变量和多变量分析来评估糖尿病、吸烟、肥胖与手术并发症之间的独立关系，并将其与无这些合并症的健康患者的发生率进行比较。我们还观察了这些合并症重叠诊断的患者。
双变量分析显示，糖尿病和吸烟者更有可能发生手术并发症。多变量分析显示，糖尿病和吸烟是并发症的独立预测因素。使患者发生术后并发症风险最高的疾病状态或组合是糖尿病-吸烟者-肥胖者、糖尿病-吸烟者、糖尿病-肥胖者、糖尿病和吸烟者-肥胖者。糖尿病-吸烟者-肥胖者的术后并发症预测率为 42.02%。
糖尿病和吸烟是 CTS、TF 和 DQ 手术治疗后并发症的独立危险因素。肥胖与糖尿病（DM）和/或吸烟并存时，会增加并发症的风险。当评估的 3 个患者因素，即 DM、肥胖和吸烟同时存在时，并发症发生率为 42.02%。在对存在这些危险因素的患者进行简单手部手术治疗之前，应进行仔细的评估和讨论。
