Does Body Mass Index Influence Time to Surgery After Diagnosis of Carpal Tunnel Syndrome?

BACKGROUND: Symptom severity, failure of conservative treatment, and health care access may influence surgical timing of carpal tunnel release (CTR) after diagnosis of carpal tunnel syndrome (CTS). However, the relationship between body mass index (BMI) and the time to surgery (TTS) after diagnosis of CTS remains unclear. The purpose of this study was to assess whether BMI is associated with TTS after CTS diagnosis.

METHODS: We conducted a retrospective cohort study using a multicenter registry to identify patients with a diagnosis of CTS. Patients were stratified into 6 BMI categories (20.0-24.9, 25.0-29.9, 30.0-34.9, 35.0-39.9, 40.0-44.9, and 45.0-49.9) The primary outcome was TTS with either open CTR or endoscopic CTR. Time to surgery was compared across groups using descriptive analysis and Kruskal-Wallis tests with post hoc Dunn test for pairwise comparisons.

RESULTS: We identified 272 713 patients with CTS. A total of 52 467 patients (19.2%) had surgical interventions including 40 297 (76.8%) with open CTR and 12 170 (23.2%) with endoscopic CTR. Body mass index was associated with a statistically significant difference in TTS in both open and endoscopic CTR (P < .001). Patients with a BMI of 45.0 to 49.9 had the greatest median length of time between diagnosis of CTS and CTR in open (94 days) and endoscopic (117 days) groups. Compared with patients with a BMI of 20.0 to 24.9, this corresponded to an increase in median time to surgery of 25 and 34 days for open and endoscopic CTR, respectively.

CONCLUSION: Body mass index was associated with significant differences in TTS following diagnosis of CTS. On average, patients with greater BMI faced longer waits from time to diagnosis of CTS to CTR with delays of approximately 3 to 5 weeks compared with patients with normal BMI.