Department of Orthopaedic Surgery, Brigham and Women's Hospital, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA.
Department of Orthopaedic Surgery, Brigham and Women's Hospital, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA.
World Neurosurg. 2021 Jul;151:e1002-e1006. doi: 10.1016/j.wneu.2021.05.031. Epub 2021 May 21.
The objectives of this study were 1) to assess the long-term patient-reported outcomes of carpal tunnel release (CTR) in patients 80 years of age or older, and 2) to determine the long-term mortality rate of this population after CTR.
We performed a retrospective study of 96 patients who underwent CTR at 80 years of age or older from July 2008 to June 2013. Mortality was assessed by medical records, the Social Security Death Index, and telephone contact. Living patients were contacted for long-term follow-up, and functional outcomes and patient satisfaction were assessed.
The mean age of the 96 patients at time of CTR was 84.1 years, including 89 octogenarian patients and 7 nonagenarian patients, and 67% were female. At an average of 9 years from surgery, the mortality rate of our cohort was 53% (51 of 96 patients). Five patients died within 1 year after CTR; no factor associated with early mortality after CTR was identified in the bivariate analysis. Telephone follow-up at an average of 9 years after CTR was available for 15 patients. Mean Boston Carpal Tunnel Syndrome Questionnaire symptom severity score was 1.6 points, mean Boston Carpal Tunnel Syndrome Questionnaire functional status score was 1.8 points, mean Quick Disabilities of the Arm, Shoulder and Hand score was 27.9, and mean satisfaction was 7.1. Eighty percent of patients reported that they would rechoose CTR.
There are long-term benefits from CTR in patients 80 years of age or older. The mortality rate of this cohort mirrors that of the general population, and CTR is justified in this elderly age group both for the magnitude and duration of treatment effect.
本研究的目的是:1)评估 80 岁及以上患者行腕管松解术(CTR)后的长期患者报告结局;2)确定该人群在接受 CTR 后的长期死亡率。
我们对 2008 年 7 月至 2013 年 6 月期间行 CTR 的 96 例 80 岁及以上患者进行了回顾性研究。通过病历、社会保障死亡指数和电话联系评估死亡率。通过医疗记录、社会保障死亡指数和电话联系评估存活患者的长期随访、功能结局和患者满意度。
96 例患者行 CTR 时的平均年龄为 84.1 岁,包括 89 例 80 岁患者和 7 例 90 岁患者,67%为女性。手术平均 9 年后,我们队列的死亡率为 53%(96 例患者中有 51 例)。5 例患者在 CTR 后 1 年内死亡;在单变量分析中未发现与 CTR 后早期死亡率相关的因素。在 CTR 后平均 9 年进行电话随访的患者有 15 例。波士顿腕管综合征问卷症状严重程度平均得分为 1.6 分,波士顿腕管综合征问卷功能状态平均得分为 1.8 分,快速上肢手部残疾问卷平均得分为 27.9 分,平均满意度为 7.1 分。80%的患者表示会再次选择 CTR。
80 岁及以上患者行 CTR 具有长期获益。该队列的死亡率与一般人群相似,并且在这个老年人群中,CTR 具有合理性,因为其治疗效果的幅度和持续时间都很长。