Comparison of Complication Risk for Open Carpal Tunnel Release: In-office versus Operating Room Settings.

Autor:	Randall DJ; Oakland University William Beaumont School of Medicine, Rochester, Mich.; Department of Orthopaedics, University of Utah, Salt Lake City, Utah., Peacock K; Institute of Clinical and Translational Sciences, Center for Administrative Data Research (CADR), Washington University in St. Louis, St. Louis, Mo., Nickel KB; Institute of Clinical and Translational Sciences, Center for Administrative Data Research (CADR), Washington University in St. Louis, St. Louis, Mo., Olsen M; Institute of Clinical and Translational Sciences, Center for Administrative Data Research (CADR), Washington University in St. Louis, St. Louis, Mo., Tyser AR; Department of Orthopaedics, University of Utah, Salt Lake City, Utah., Kazmers NH; Department of Orthopaedics, University of Utah, Salt Lake City, Utah.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery. Global open [Plast Reconstr Surg Glob Open] 2021 Jul 12; Vol. 9 (7), pp. e3685. Date of Electronic Publication: 2021 Jul 12 (Print Publication: 2021).
DOI:	10.1097/GOX.0000000000003685
Abstrakt:	Background: Performing open carpal tunnel release (oCTR) in an office-based procedure room setting (PR) decreases surgical costs when compared with the operating room (OR). However, it is unclear if the risk of major medical, wound, and iatrogenic complications differ between settings. Our purpose was to compare the risk of major medical complications associated with oCTR between PR and OR settings. Methods: Utilizing the MarketScan Database, we identified adults undergoing isolated oCTR between 2006 and 2015 performed in PR and OR settings. ICD-9-CM and/or CPT codes were used to identify major medical complications, surgical site complications, and iatrogenic complications within 90 days of oCTR. Multivariable logistic regression was used to compare complication risk between groups. Results: Of the 2134 PR and 76,216 OR cases, the risk of major medical complications was 0.89% (19/2134) and 1.20% (914/76,216), respectively, with no difference observed in the multivariable analysis (adjusted odds ratio [OR] 0.84; 95% CI 0.53-1.33; P =0.45). Risk of surgical site complications was 0.56% (12/2134) and 0.81% (616/76,216) for the PR and OR, respectively, with no difference in the multivariable analysis (OR 0.68; 95% C.I. 0.38-1.22; P =0.19). Iatrogenic complications were rarely observed (PR 1/2134 [0.05%], OR 71/76,216 [0.09%]), which precluded multivariable modeling. Conclusion: These results support a similar safety profile for both the PR and OR surgical settings following oCTR with similar pooled major medical complications, pooled wound/surgical site complications, and iatrogenic complications. Competing Interests: Disclosure: All the authors have no financial interest to declare in relation to the content of this article. Investigational support was provided to The Center for Administrative Data Research at the Washington University in St. Louis in part by awards from the NIH (UL1 TR002345) and AHRQ (R24 HS19455). (Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)
Databáze:	MEDLINE
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