A simple preoperative work-related suffering score predicts prolonged sick leave after mini-open carpal tunnel...

The duration of sick leave following carpal tunnel surgery remains highly variable and likely depends on factors beyond mere anatomical or electrophysiological severity. We evaluated the utility of a simple score based on the number of instances of discomfort spontaneously reported by the patient during the preoperative consultation.

A single-centre retrospective study included 71 patients who underwent mini-open release surgery for carpal tunnel syndrome. A symptom severity score was constructed based on factors spontaneously mentioned by the patient as contributing to their symptoms or work-related discomfort. The primary outcome measure was the duration of sick leave.

The burden score was associated with prolonged sick leave following surgery. Each additional occurrence increased the probability of prolonged sick leave. ROC analysis identified a relevant threshold from 2 occurrences. A simple stratification identified three clinical profiles: low risk for 0-1 occurrence, intermediate risk for 2-3 occurrences, and high risk from 4 occurrences onwards. Recognition as an occupational disease was also associated with prolonged sick leave. These results suggest that a simple clinical indicator, collected without a complex questionnaire, can help anticipate socio-occupational outcomes.

This pragmatic score, based on the patient's spontaneous account, forms part of a biopsychosocial approach to carpal tunnel syndrome. Its main advantage is its ease of use in routine consultations. It could enable the early identification of patients at risk of prolonged sick leave and allow for the adaptation of information, follow-up and medical-occupational planning. Prospective validation in an external cohort remains necessary.

IV, retrospective study.