The Risk of Complications after Carpal Tunnel Release in Patients Taking Acetylsalicylic Acid as Platelet Inhibition: A Multicenter Propensity Score-Matched Study

Alexander Kaltenborn*, Stefanie Frey-Wille, Sebastian Hoffmann, Joern Wille, Christoph Schulze, Andreas Settje, Peter M. Vogt, Andre Gutcke, Mike Ruettermann

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    2 Citations (Scopus)
    16 Downloads (Pure)

    Abstract

    Background:

    Carpal tunnel release is one of the most common procedures in hand surgery. There is only scarce evidence regarding whether platelet inhibitors increase the risk of developing postoperative hemorrhage in carpal tunnel release.

    Methods:

    This is a multicenter, propensity score-matched study including 635 carpal tunnel releases in 497 patients. Multivariate regression models were adjusted with the propensity score, which was developed to mitigate differences in patients with and without platelet inhibition with acetylsalicylic acid. Propensity score matching provides results close to the statistical quality of randomized controlled trials. The primary study endpoint was postoperative bleeding complication, defined as acute bleeding leading to reoperation or hematoma leading to physician visit. Patient satisfaction, functional outcome measured with the Boston Carpal Tunnel Questionnaire, and onset of surgical-site infection were also analyzed.

    Results:

    Bleeding complications were observed in 56 procedures (8.8 percent). After propensity score matching, there was no significant difference between the patients with and without acetylsalicylic acid treatment (p = 0.997). History of thyroid disease (p = 0.035) and of rheumatoid arthritis (p = 0.026) were independent risk factors, whereas higher body mass index might have a beneficial effect (p = 0.006). Patients with postoperative bleeding had significantly impaired functional outcome as measured with the Boston Carpal Tunnel Questionnaire (p = 0.026). Median satisfaction in the investigated study population was 10 of 10 points and did not differ significantly between the antiplatelet and the non-antiplatelet cohorts (p = 0.072)

    Conclusion:

    Carpal tunnel release under platelet inhibition with acetylsalicylic acid is safe and can be performed without interruption of such medication.

    Original languageEnglish
    Pages (from-to)360E-367E
    Number of pages8
    JournalPlastic and Reconstructive Surgery
    Volume145
    Issue number2
    DOIs
    Publication statusPublished - Feb-2020

    Keywords

    • BODY-MASS INDEX
    • THYROID-DISORDERS
    • SURGERY
    • IMPACT
    • HAND

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