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. 2021 Dec 23;16(12):e0260578.
doi: 10.1371/journal.pone.0260578. eCollection 2021.

Prevalence and predictive factors for bilateral carpal tunnel syndrome by electrodiagnosis: A retrospective study

Apiradee Singjam  1 , Kanchana Charoentanyarak  1 , Jittima Saengsuwan  2
Affiliations

Prevalence and predictive factors for bilateral carpal tunnel syndrome by electrodiagnosis: A retrospective study

Apiradee Singjam et al. PLoS One. .

Abstract

Introduction: Carpal tunnel syndrome (CTS) is the most common compressive neuropathy. Patients who have unilateral symptoms are frequently found to have bilateral CTS by electrodiagnostic (EDx) study. We aimed to (a) study the prevalence and identify the predictive factors for bilateral CTS diagnosed by EDx; and (b) develop a model to predict bilateral CTS.

Methods: The retrospective clinical and EDx data of patients with CTS were collected and analyzed using the Chi-squared test and multiple logistic regression analysis. A model was fitted, and the best cutoff point determined. Calibration and discrimination performance of the model were performed.

Results: A total of 327 patients with a mean age of 50.0 years were enrolled. Most were women (82.6%), and the most common presenting symptom was hand numbness (93.6%). The median duration of symptoms was 60 days. The prevalence of bilateral CTS was 80.7%. In the multivariate analysis, the predictive factors for bilateral CTS were the presence of bilateral symptoms (AOR 6.7 [95%CI 3.1-14.3]), thenar muscle weakness (AOR 3.9 [95%CI 1.3-11.6]), and age ≥ 45 years (AOR 2.5 [95%CI 1.3-4.6]). The logistic regression model was fitted, and the best cutoff point determined. The area under the receiver operating curve (AUC) was 0.76. The respective optimism-corrected C index and Somers' D was 0.762 and 0.524.

Conclusion: The prevalence of bilateral CTS was 80.7%. Our findings suggest bilateral CTS was predicted with adequate diagnostic accuracy by bilateral symptoms, age ≥ 45 years, and thenar muscle weakness.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. ROC curves–plot of sensitivity versus 1-specificity values for the model: Bilateral CTS score = 0.1 + (1.4 x thenar muscle weakness) + (1.9 x bilateral symptoms) + (0.9 x AGE ≥ 45 yrs).
Scoring: thenar muscle weakness: no = 0, yes = 1; Bilateral symptoms: no = 0, yes = 1; and age ≥45 years: no = 0, yes = 1. The best cutoff score was 2.0.
See this image and copyright information in PMC

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