Hypercholesterolemia is associated with the subjective evaluation of postoperative outcomes in patients with idiopathic carpal tunnel syndrome who undergo surgery: a multivariate analysis

Background: Carpal tunnel syndrome (CTS) is a compression neuropathy of the median nerve at the wrist; its symptoms include neuropathic pain and sensory and motor disturbance distributed by the median nerve. CTS and hypercholesterolemia have similar backgrounds, but the effect of these similarities on postoperative outcomes has not been reported. Using multivariate analysis, we analyzed the relationship between patients' subjective opinion of their postoperative symptoms compared to preoperative symptoms and prognostic factors, focusing on hypercholesterolemia in patients with idiopathic CTS treated surgically. Methods: Out of 168 hands with CTS that were surgically treated, 141 that were followed up and assessed 1 year postoperatively or thereafter were included. The mean postoperative follow-up period was 40.8 months. Surgery was performed through a small palmar skin incision under local anesthesia. The outcomes were postoperative symptoms, including pain and numbness, and overall Kelly assessment. Results: Preoperative numbness and pain resolved in 94 of 141 hands and alleviated in 59 of 64 hands. Univariate analysis showed that postoperative numbness and Kelly assessment were significantly associated with hypercholesterolemia. Multivariate analysis showed that postoperative numbness was significantly associated with smoking and hypercholesterolemia, and Kelly assessment was significantly associated with smoking (adjusted OR: 3.3; 95% CI: 1.1–10; p=0.04) and hypercholesterolemia (adjusted OR: 2.9; 95% CI: 1.4–6.3; p=0.01). Conclusions: Hypercholesterolemia, usually a systemic condition in sites other than the hand, is associated with the subjective evaluation of postoperative symptoms in patients with idiopathic CTS. Presented at: Annual Meeting of the Japanese Society for Surgery of the Hand in 2016 in Japan Financial disclosure statement: No disclosure Authorship: KY: data collection, interpretation of data, statistical analysis, and writing of the manuscript. AK, MI, KS, and YK: setting up the project and interpretation of data. TE: conception of the study design and interpretation of data. KY, AK, MI, YK, and TE: revising the manuscript. Ethical considerations: This study was approved by our institutional review board and conformed to the Declaration of Helsinki. Acknowledgements: We thank for Kyoko Kondo for advice on the biostatistical analysis. Corresponding author: Koichi Yano, Department of Orthopaedic Surgery, Seikeikai Hospital, Address: Minamiyasuicho 1-1-1, Sakai-ku, Sakai City, Osaka, Japan. E-mail: koichiyano@hotmail.com ©2018American Society of Plastic Surgeons

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