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Observational Study
. 2018 Jun 19;8(6):e020166.
doi: 10.1136/bmjopen-2017-020166.

Trends in the prevalence, incidence and surgical management of carpal tunnel syndrome between 1993 and 2013: an observational analysis of UK primary care records

Claire L Burton  1 , Ying Chen  1 , Linda S Chesterton  1 , Danielle A van der Windt  1
Affiliations
Observational Study

Trends in the prevalence, incidence and surgical management of carpal tunnel syndrome between 1993 and 2013: an observational analysis of UK primary care records

Claire L Burton et al. BMJ Open. .

Abstract

Objectives: To describe the prevalence, incidence and surgical management of carpal tunnel syndrome (CTS), between 1993 and 2013, as recorded in the Clinical Practice Research Datalink (CPRD).

Design: We completed a series of cross-sectional epidemiological analyses to observe trends over time.

Setting: Primary care data collected between 1993 and 2013, stored in the CPRD.

Population: Individuals aged ≥18 years were selected. Prevalent and incident episodes of CTS and episodes of surgical intervention were identified using a list of preidentified Read codes.

Analysis: We defined incident episodes as those with no preceding diagnostic code for CTS in the past 2 years of data. Episodes of surgery were expressed as a percentage of the prevalent population during the same calendar year. Joinpoint regression was used to determine significant changes in the underlying trend.

Results: The prevalence of CTS increased over the study period, with a particular incline between 2000 and 2004 (annual percentage change 7.81). The female-to-male prevalence ratio reduced over time from 2.74 in 1993 to 1.93 in 2013. The median age of females and males with CTS were noted to increase from 49 and 53 years, respectively in 1993 to 54 and 59 years, respectively in 2013. Incidence was also noted to increase over time. After an initial increase between 1993 and 2007, the percentage of prevalent patients with a coded surgical episode began to decrease after 2007 to 27.41% in 2013 (annual percentage change -1.7).

Conclusion: This study has demonstrated that the prevalence and incidence of CTS increased over the study period between 1993 and 2013. Rates of surgery for CTS also increased over the study period; however after 2007, the per cent of patients receiving surgery showed a statistically significant decline back to the rate seen in 2004.

Keywords: musculoskeletal disorders; primary care; surgery.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Joinpoint analysis of the crude prevalence of carpal tunnel syndrome between 1993 and 2013. ^, reflects significance at the 0.05 level; APC, annual percentage change.
Figure 2
Figure 2
Joinpoint analysis of the crude incidence of carpal tunnel syndrome between 1993 and 2013. ^, reflects significance at the 0.05 level; APC, annual percentage change.
Figure 3
Figure 3
Joinpoint analysis of the percentage of prevalent patients with a recorded episode of carpal tunnel release, in each calendar year syndrome, between 1993 and 2013. ^, reflects significance at the 0.05 level; APC, annual percentage change.
See this image and copyright information in PMC

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