2010 至 2021 年开放式与内窥镜腕管松解术的发展趋势

Philip P. Ratnasamy, Katelyn E. Rudisill, Peter Y Joo, Lisa L. Lattanza, Jonathan N. Grauer
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摘要

背景:本研究利用国家行政数据库,比较了 2010 年至 2021 年内窥镜腕管松解术(ECTR)与开放式腕管松解术(OCTR)的使用趋势、预测因素和报销情况。方法:从 PearlDiver M151Ortho 数据集中识别出 ECTR 和 OCTR 患者。在研究的每一年中,这些手术的使用数量和比例都有特征。进行了多变量分析,以确定进行 ECTR 的预测因素。确定了 ECTR 和 OCTR 的 90 天平均报销额。结果:从 2010 年到 2021 年,共确定了 441,023 例 ECTR 和 1,767,820 例 OCTR 手术。与OCTR相比,ECTR的使用比例从2010年的15.7%上升到2021年的26.1%。进行ECTR而非OCTR的独立预测因素包括地域差异(与在中西部进行手术相比,东北部的几率比[OR]为1.53;西部的几率比为1.62;南部的几率比为1.66)、拥有医疗保险或商业保险(与商业保险相比,医疗保险的几率比为0.94,医疗补助的几率比为0.69)、女性和较少的合并症。ECTR的90天平均报销额为3,114.82美元,而OCTR为3,087.62美元。讨论:截至 2021 年,超过四分之一的腕管松解术是通过内窥镜完成的。有几个因素可独立预测患者是接受 ECTR 还是 OCTR。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Trends in Open Versus Endoscopic Carpal Tunnel Release From 2010 to 2021
Background: This study compared trends in use, predictive factors, and reimbursement of endoscopic carpal tunnel release (ECTR) withthose of open carpal tunnel release (OCTR) from 2010 to 2021 using a national administrative database. Methods: ECTR and OCTR patients were identified in the PearlDiver M151Ortho data set. Numeric and proportional utilization of these procedures was characterized for each year of study. Multivariate analysis was conducted to identify predictive factors for having ECTR performed. The average 90-day reimbursement of ECTR and OCTR was determined. Results: From 2010 through 2021, 441,023 ECTR and 1,767,820 OCTR procedures were identified. The proportional use of ECTR compared with OCTR rose from 2010 (15.7% of procedures) to 2021 (26.1%). Independent predictors of having ECTR performed rather than OCTR included geographic variation (compared with having surgery in the Midwest, Northeast odds ratio [OR], 1.53; West OR, 1.62; and South OR, 1.66), having Medicare or commercial insurance (compared with commercial, Medicare OR, 0.94, and Medicaid OR, 0.69), female sex, and fewer comorbidities. The average 90-day reimbursement for ECTR was $3,114.82, compared with $3,087.62 for OCTR. Discussion: As of 2021, over one-fourth of carpal tunnel releases are done endoscopically. Several factors independently predict whether patients receive ECTR or OCTR.
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