A preliminary scoring system for assessing the outcome of carpal tunnel release

Abstract

Multiple outcomes are assessed in most studies of carpal tunnel syndrome, yet there are no validated methods of synthesizing these distinct measures into a single global score. We report a global score in which outcomes were selected and weighted according to their independent association with patient satisfaction with the results of surgery. Preoperative and 3-month follow-up data were analyzed on 104 subjects in a randomized controlled trial of open vs endoscopic carpal tunnel release. Patient satisfaction with surgery and a variety of subjective and objective outcome parameters were measured. In multivariate analyses, independent correlates of dissatisfaction included persistent numbness and paresthesia, incisional pain at follow-up evaluation, and decrease in grip strength. A global score was calculated by rounding to the nearest integer the model coefficients for these three variables. The global score correlated with patient satisfaction with surgery and time until return to work or full activities in patients undergoing open carpal tunnel release.