Incidence of Heart Failure Following Carpal Tunnel Release Surgery

Abstract

Purpose

Previous literature suggests a relationship between carpal tunnel syndrome (CTS) and heart failure (HF), indicating that patients with CTS are more likely to experience cardiomyopathy. Amyloid deposition leading to CTS may be prodromal for the development of amyloid cardiomyopathy. We hypothesized that patients undergoing surgery for CTS would have an increased risk of HF compared to those who did not undergo surgery.

Methods

The TriNetX database was queried using the primary ICD-10 code for CTS to identify patients. Patients were included if they had surgical treatment for CTS, reported as endoscopic or open carpal tunnel release, or median nerve release. The primary outcome was HF. Propensity scoring adjusted for demographics and comorbidities. Statistical significance was set at P < .05, and odds ratios were calculated at 95% confidence intervals (CI).

Results

The incidence of HF in patients who underwent carpal tunnel release was 3.49%, 5.98%, 6.947%, and 7.102% at 5, 10, 15, and 20 years after surgery. Compared to nonsurgical patients, the risk difference of 0.399 (95% CI, 0.202–0.596) became statistically significant at five years (P < .0001) with an increased risk ratio (RR) of 1.129 (95% CI, 1.0063–1.198) for surgical patients. The risk difference peaked at 2.007% (95% CI, 1.744–2.27) at the 20-year mark with an RR of 1.369 (95% CI, 1.311–1.456).

Conclusions

This study demonstrates that patients who underwent carpal tunnel release were more likely to experience HF than nonsurgical matched controls. It also showed an increased association with CTS and HF compared to HF progression in the general population In CTS patients with a higher risk of heart failure, hand surgeons can have a crucial role in early identification and facilitating further cardiovascular assessment.

Type of study/level of evidence

Prognostic IV.