LAUSR

BACKGROUND The Boston Carpal Tunnel Questionnaire (BCTQ) is a validated measurement tool for the severity of carpal tunnel syndrome (CTS) and improvements in the BCTQ following carpal tunnel release (CTR) have been demonstrated to influence patient satisfaction. We hypothesized that patient-related factors influence response in BCTQ subscales including the symptom severity scale (SSS) and the functional status scale (FSS) following CTR. METHODS Patients who underwent surgery with follow-up BCTQ were identified from a prospectively maintained database. Paired t-tests were used to compare BCTQ sub-scales at each follow-up time point. Minimal clinically important differences (MCID) were set. Patients below these thresholds were deemed as failures to improve following CTR. Univariate analysis was used to identify risk factors for failure to improve following CTR. Multi-variate logistic regression was used to identify independent predictors for failure to improve following CTR. RESULTS 106 patients met inclusion criteria. Patients demonstrated significant improvements at all follow-up time points. The factor most associated with improvement beyond the MCID was a more severe score in the respective domain assessed. Other independent factors that influenced outcome following CTR included ethnicity, concomitant cubital tunnel release, gender, and age. CONCLUSIONS CTR results in significant improvements in BCTQ and its subscales with improvements stabilizing after six weeks. A select cohort of patients fails to improve following CTR with factors independently associated with a lower degree of improvement. Identification of patients with these risk factors will provide a basis for counseling and increased monitoring of patients at risk for a guarded prognosis.