2017 Reports

Validation of known risk factors associated with carpal tunnel syndrome: A retrospective nationwide 11-year population-based cohort study in South Korea

Lee, Hong-Jae; Lim, Hyun-Sun; Kim, Hyoung Seop

Importance
There have been few large-scale studies that have included a risk factor analysis for CTS. No prior study has investigated and validated the relationship between the occurrence of CTS and known risk factors using nationwide health care database.
Objective
To confirm the actual risk factors for CTS out of various known risk factors
Design
We conducted this study using a retrospective cohort model based on the combined two databases of the Korean National Health Insurance System; the national periodic health screening program database from 2002–2003 and health insurance database of reimbursement claims from 2003 through 2013.
Setting
A population-based retrospective cohort study.
Participants
First, we randomly sampled 514,795 patients who represented 10% of the 5,147,950 people who took part in periodic health screenings in 2002–2003. Existing CTS patients were excluded from this group. Therefore, this study finally included 512,942 participants and followed up their medical records from 2003–2013.
Main Outcomes and Measures
Desired outcomes were the incidence rate of CTS in patients with various risk factors and the hazard ratios of risk factors affecting the disease’s occurrence.
Results
The incidence of CTS was highest in patients in the age of 40s, in the moderate obesity group, in females, and in patients with diabetes mellitus (DM). The hazard ratio analysis revealed that the following risk factors were strongly related to the occurrence of CTS: age of 40s, female, obesity, DM, rheumatoid arthritis, gout, and Raynaud’s syndrome. However, ESRD, hypothyroidism and smoking were not correlated with CTS occurrence.
Conclusions and Relevance
In our large-scale cohort study, risk factors such as being in one’s 40s, obesity, being female, suffering from DM, and rheumatoid arthritis were reaffirmed as those of CTS occurrence.