Chen Shirley, Portnoy Antoinette, Tabbaa Ameer, Voyvodic Lucas, Diamond Keith, Horn Andrew, Razi Afshin E, Choueka Jack
Maimonides Medical Center, Department of Orthopaedic Surgery, Brooklyn, NY, USA.
State University of New York (SUNY) Downstate, College of Medicine, Brooklyn, NY, USA.
J Orthop. 2024 Jun 17;57:127-132. doi: 10.1016/j.jor.2024.06.020. eCollection 2024 Nov.
Guyon's Canal Syndrome (GCS) is a rare nerve entrapment condition with limited studies exploring the trends of GCS patients undergoing Guyon's Canal release. The aim of this study is to examine the trends associated with GCS: (1) Guyon's Canal release procedures performed; (2) surgically relevant comorbidities; (3) 90-day readmissions; and (4) same-day and 90-day reimbursement.
A retrospective query was performed on the PearlDiver Mariner Database from 2010 to 2020 by CPT code 64719 to identify patients who underwent Guyon's Canal release. A total of 33,3764 patients were identified. Linear regression models were used to analyze trends in procedures performed, comorbidities, readmission, and reimbursement over this period. A P-value less than 0.05 was considered statistically significant.
Between 2010 and 2020, there was an overall significant decreasing trend in the number of Guyon's Canal release procedures performed (RC, -127.50; p < 0.001). There was an increase in number of GCS patients that had undergone Guyon's Canal release who drink alcohol (RC, 0.33; p < 0.001), are obese (RC, 0.81; p < 0.001), and use tobacco (RC, 0.56; p < 0.004), and decrease number of GCS patients with a history of diabetes (RC, -0.82; p < 0.001), hypothyroidism (RC, -0.56; p < 0.001), PVD (RC, -0.71; p < 0.001), and RA (RC, -0.33; p < 0.001). We also found an overall increasing trend in 90-day readmissions (RC, 0.09; p = 0.019) and increased same-day (RC, 68.09; p < 0.001) and 90-day average reimbursement (RC, 257.15; p < 0.001) from 2010 to 2020.
The study demonstrated a decreasing trend in Guyon's Canal release performed in GCS patients but increasing cost of care implicated by the increased 90-day readmissions and same day and 90-day reimbursement. This may be attributed to the comorbidities present in GCS patients undergoing Guyon's Canal release. Therefore, it is imperative when consulting GCS patients with surgically relevant comorbidities to weigh the risk and benefits of the procedure.
盖氏管综合征（GCS）是一种罕见的神经卡压疾病，针对接受盖氏管松解术的GCS患者的研究趋势有限。本研究的目的是探讨与GCS相关的趋势：（1）进行的盖氏管松解手术；（2）手术相关合并症；（3）90天再入院情况；（4）当日及90天报销情况。
通过CPT编码64719对2010年至2020年的PearlDiver Mariner数据库进行回顾性查询，以识别接受盖氏管松解术的患者。共识别出333764例患者。使用线性回归模型分析在此期间手术、合并症、再入院和报销的趋势。P值小于0.05被认为具有统计学意义。
2010年至2020年期间，进行的盖氏管松解手术数量总体呈显著下降趋势（回归系数[RC]，-127.50；p<0.001）。接受盖氏管松解术的GCS患者中，饮酒者（RC，0.33；p<0.001）、肥胖者（RC，0.81；p<0.001）和吸烟者（RC，0.56；p<0.004）的数量增加，而有糖尿病史（RC，-0.82；p<0.001）、甲状腺功能减退史（RC，-0.56；p<0.001）、外周血管疾病史（RC，-0.71；p<0.001）和类风湿性关节炎史（RC=-0.33；p<0.001）的GCS患者数量减少。我们还发现90天再入院率总体呈上升趋势（RC，0.09；p=0.019），2010年至2020年当日（RC，68.09；p<0.001）及90天平均报销费用增加（RC，257.15；p<0.001）。
该研究表明GCS患者接受盖氏管松解术的趋势呈下降，但90天再入院率增加以及当日和90天报销费用增加意味着护理成本上升。这可能归因于接受盖氏管松解术的GCS患者存在的合并症。因此，在为有手术相关合并症的GCS患者提供咨询时，必须权衡手术的风险和益处。
