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Increased Risk of Carpal Tunnel Syndrome in People With Spinal Cord Injury: A Nationwide Longitudinal Follow-Up Study

  • Yi-Hsiang Chiu
    Affiliations
    Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei
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  • Kuo-Cheng Yeh
    Affiliations
    Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, Taipei, Taiwan
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  • Shin-Liang Pan
    Correspondence
    Corresponding author Shin-Liang Pan, MD, PhD, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei City 100, Taiwan. Tel.: 886-2-23123456 ext. 67749.
    Affiliations
    Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei

    Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, Taipei, Taiwan
    Search for articles by this author
Published:August 20, 2021DOI:https://doi.org/10.1016/j.apmr.2021.07.804

      Abstract

      Objective

      To investigate the long-term risk of carpal tunnel syndrome (CTS) in people with spinal cord injury (SCI).

      Design

      Retrospective cohort study.

      Setting

      Taiwan's Longitudinal Health Insurance Database 2005, containing data about 1 million people randomly sampled from among those registered in the National Health Insurance Program as of 2005.

      Participants

      The SCI group consisted of 1681 subjects with SCI, and the comparison group comprised 6724 propensity score-matched subjects without SCI (N=8405). The variables included in propensity-score matching were age, sex, comorbid conditions, and socioeconomic status.

      Interventions

      Not applicable.

      Main Outcome Measures

      The occurrence of newly diagnosed CTS, defined by at least 1 hospital discharge or 2 outpatient visits with a diagnosis of CTS.

      Results

      The incidence density of CTS in the SCI group was 7.55 per 1000 person-years (95% confidence interval [CI], 6.03-9.33), and in the comparison group, 4.61 per 1000 person-years (95% CI, 4.08-5.19). The hazard ratio (HR) of CTS for the SCI group was therefore 1.59 (95% CI, 1.24-2.03). Additionally, the HR of CTS for the cervical-SCI subgroup, 1.90 (95% CI, 1.21-2.97) was considerably higher than that of its noncervical counterpart, 1.47 (95% CI, 1.09-1.98).

      Conclusions

      People with both cervical and noncervical SCI have an increased risk of developing CTS, as compared with those without SCI. Moreover, the CTS risk appears to be higher for individuals with cervical SCI than their noncervical SCI counterparts.

      Keywords

      List of abbreviations:

      CI (confidence interval), CTS (carpal tunnel syndrome), COPD (chronic obstructive pulmonary disease), HR (hazard ratio), ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification), LHID2005 (Longitudinal Health Insurance Database 2005), NHI (National Health Insurance), NT$ (New Taiwan dollar), SCI (spinal cord injury)
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