Zhang Dafang, Blazar Philip, Earp Brandon E
Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Mass.
Harvard Medical School, Boston, Mass.
Plast Reconstr Surg Glob Open. 2023 Mar 13;11(3):e4878. doi: 10.1097/GOX.0000000000004878. eCollection 2023 Mar.
The primary objective of this study was to determine the association between socioeconomic disparity and improvement in QuickDASH score 3 months after carpal tunnel release (CTR). The secondary objectives of this study were to determine the association between socioeconomic disparity and baseline preoperative QuickDASH score and 3 months postoperative QuickDASH score after CTR.
A single-institutional, prospective, longitudinal study was performed of 85 patients who underwent isolated, unilateral CTR for idiopathic carpal tunnel syndrome. Sixty-three patients (74%) who completed patient-reported outcome measures at 3 months after surgery comprised our study cohort. Socioeconomic disparity was assessed using the zip code level Distressed Communities Index (DCI) and the neighborhood level Area Deprivation Index. The outcome variables were the improvement in the QuickDASH score, 3 months postoperative QuickDASH score, and the preoperative QuickDASH score. Associations between continuous variables were assessed using simple linear regression.
The mean DCI of the study cohort was in the 23rd national percentile, and the mean Area Deprivation Index was in the 15th national percentile. The mean preoperative QuickDASH of the study cohort was 49.3. The mean 3 months postoperative QuickDASH of the study cohort was 29.8. The mean improvement in QuickDASH at 3 months after surgery was 19.5, which was statistically significant and clinically meaningful. Area Deprivation Index and DCI were not associated with improvement in QuickDASH score or 3 months postoperative QuickDASH score. Higher DCI was associated with poorer baseline preoperative QuickDASH score.
Patients of various socioeconomic backgrounds can expect similar short-term improvements in symptoms and function after CTR.
本研究的主要目的是确定社会经济差异与腕管松解术（CTR）3个月后QuickDASH评分改善之间的关联。本研究的次要目的是确定社会经济差异与CTR术前基线QuickDASH评分和术后3个月QuickDASH评分之间的关联。
对85例因特发性腕管综合征接受孤立性、单侧CTR的患者进行了一项单机构、前瞻性、纵向研究。63例（74%）在术后3个月完成患者报告结局测量的患者组成了我们的研究队列。使用邮政编码水平的困境社区指数（DCI）和邻里水平的区域剥夺指数评估社会经济差异。结局变量为QuickDASH评分的改善情况、术后3个月的QuickDASH评分和术前QuickDASH评分。使用简单线性回归评估连续变量之间的关联。
研究队列的平均DCI处于全国第23百分位，平均区域剥夺指数处于全国第15百分位。研究队列术前QuickDASH的平均值为49.3。研究队列术后3个月QuickDASH的平均值为29.8。术后3个月QuickDASH的平均改善值为19.5，具有统计学意义且具有临床意义。区域剥夺指数和DCI与QuickDASH评分的改善或术后3个月的QuickDASH评分无关。较高的DCI与较差的术前基线QuickDASH评分相关。
不同社会经济背景的患者在CTR术后短期内症状和功能有望得到相似的改善。
