title: Relationship between the duration and severity of symptoms and the outcome of carpal tunnel surgery.
abstract: OBJECTIVE
  There is no consensus regarding the prognostic value of preoperative symptom severity and duration for determining the anticipated results of carpal tunnel release. Some studies show a detrimental influence of symptom duration and severity on outcomes; others have found no effect. To study these contradictions, a database was created at 2 separate hand centers to explore the extent to which the duration and severity of symptoms before surgery are predictive of surgical outcome.
  
  
  METHODS
  At 2 hand centers 523 hands from the United States and United Kingdom completed surgery and follow-up evaluation. Symptoms, time of onset, duration, prior treatment, and medical history were recorded. Each patient had a physical examination and completed the Levine-Katz questionnaire.
  
  
  RESULTS
  Symptom duration, corrected for gender, was not associated with Levine-Katz symptom severity, Levine-Katz functional status, or changes in these scores from the pretreatment to 6-month follow-up evaluations.
  
  
  CONCLUSIONS
  Preoperative symptom duration does not affect the surgery outcome as determined by the Levine-Katz symptom severity or functional status scores. The more severe the symptoms as determined by patient self-assessment, the greater the amount of change in the Levine-Katz symptom severity and functional status scores, although at 6 months after surgery the scores were still higher than those of patients with milder cases.
authors.affiliation: The Pulvertaft Hand Centre, Derbyshire Royal Infirmary, Derby, England.
authors.forename: Frank D
authors.initials: FD
authors.lastname: Burke
authors.forename: E F Shaw
authors.initials: EF
authors.lastname: Wilgis
authors.forename: Norman H
authors.initials: NH
authors.lastname: Dubin
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Bradley
authors.forename: Shiladitya
authors.initials: S
authors.lastname: Sinha
mesh_terms: D000367:Age Factors; D002349:Carpal Tunnel Syndrome / Q000601:surgery*; D019992:Databases as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011300:Preoperative Care; D012720:Severity of Illness Index; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D006113:United Kingdom; D014481:United States