SUPPLEMENTAL DIGITAL CONTENT 2. Cumulative incidence of any type of carpal tunnel syndrome overall and in strata by age at oophorectomy, estrogen therapy, body mass index, parity, and surgical indication
Bilateral oophorectomy Referent women Unadjusted modelsa Adjusted modelsb
Strata N at
risk Person-
years N of
events Absolute riskc
(95% CI) N at
risk Person -years N of
events Absolute riskc
(95% CI) Hazard ratio
(95% CI) P Hazard ratio
(95% CI) P
Overall 1,399 18,778 192 17.1% (14.7-19.8) 1,478 19,976 152 13.5% (11.4-16.0) 1.34 (1.09-1.66) 0.006 1.26 (1.02-1.56) 0.03 Age ≤45 y 870 11,731 118 16.6% (13.8-20.0) 939 12,555 98 14.3% (11.5-17.7) 1.29 (0.99-1.68) 0.06 1.24 (0.94-1.63) 0.12 ET >45d 532 6,444 55 14.7% (10.8-19.8) 526 6,282 50 14.8% (10.7-20.2) 1.07 (0.73-1.57) 0.73 1.06 (0.72-1.57) 0.76 No ET or ≤45 136 1,284 10 9.0% (4.2-18.6) 142 1,347 16 13.0% (7.2-23.0) 0.65 (0.30-1.43) 0.29 0.63 (0.26-1.49) 0.29 Age 46 to 49 y 529 7,048 74 18.0% (14.1-22.9) 539 7,421 54 11.5% (8.6-15.3) 1.44 (1.02-2.03) 0.04 1.37 (0.96-1.96) 0.08 ET >49e 385 4,835 49 18.6% (13.0-26.2) 363 4,757 35 13.3% (9.1-19.2) 1.38 (0.90-2.10) 0.14 1.17 (0.75-1.81) 0.48 No ET or ≤49 120 1,143 12 15.7% (7.3-31.9) 132 1,344 11 10.3% (5.1-20.0) 1.29 (0.58-2.90) 0.54 1.20 (0.51-2.83) 0.68 BMI <30 kg/m2 959 13,240 118 15.8% (13.1-19.0) 1,104 14,992 100 11.1% (9.0-13.7) 1.33 (1.02-1.74) 0.03 1.35 (1.03-1.76) 0.03 BMI ≥30 kg/m2 440 5,538 74 21.4% (16.7-27.2) 374 4,985 52 20.0% (14.8-26.7) 1.29 (0.92-1.82) 0.14 1.21 (0.85-1.73) 0.29 Nulliparous 267 3,522 42 20.9% (15.2-28.4) 254 3,332 26 12.5% (8.2-18.8) 1.50 (0.93-2.41) 0.10 1.48 (0.91-2.43) 0.12 Parity ≥1 1,132 15,257 150 16.3% (13.7-19.2) 1,224 16,645 126 13.7% (11.3-16.5) 1.30 (1.03-1.64) 0.03 1.21 (0.95-1.54) 0.11 Benign indicationf 577 7,644 91 21.1% (17.0-25.9) 616 8,418 55 11.6% (8.7-15.4) 1.81 (1.30-2.53) <0.001 1.77 (1.26-2.48) <0.001 No indicationg 822 11,135 101 14.3% (11.5-17.6) 862 11,558 97 14.7% (11.9-18.2) 1.08 (0.82-1.43) 0.57 1.00 (0.75-1.32) 0.98 BMI, body mass index; CI, confidence interval; ET, estrogen therapy.
a Hazard ratios were calculated using Cox proportional hazards models with age as the time scale.
b Hazard ratios were calculated using Cox proportional hazards models with age as the time scale and adjusted using inverse probability weights derived from a logistic regression model including 18 chronic conditions present at baseline, years of education (≤12, 13-16, >16), quartiles of household income (<$42,000, $42,000-56,999,
$57,000-71,999, ≥$72,000), race (white vs nonwhite), BMI (<30 vs ≥30 kg/m2), cigarette smoking (current or former vs never), age at index date (continuous), and calendar year at index date (continuous). These adjustments were done separately in each stratum to maximize the balance at index date. A significant interaction was found by indication (P=0.01), but no significant interactions were found by age (P=0.65), estrogen therapy (age ≤45 P=0.29, age 46-49 P=0.97), BMI (P=0.62), or by parity (P=0.44).
SUPPLEMENTAL DIGITAL CONTENT 2. Continued
c Absolute cumulative risk at 20 years after bilateral oophorectomy (or index) calculated using the Kaplan-Meier method. The estimates were adjusted using inverse probability weights derived from a logistic regression model including 18 chronic conditions present at baseline, years of education (≤12, 13-16, >16), quartiles of household income (<$42,000, $42,000-56,999, $57,000-71,999, ≥$72,000), race (white vs nonwhite), BMI (<30 vs ≥30 kg/m2), cigarette smoking (current or former vs never), age at index date (continuous), and calendar year at index date (continuous). These adjustments were done separately in each stratum to maximize the balance at index date.
d Women who were taking systemic ET (only oral or transdermal) on their 46th birth date, after bilateral oophorectomy. Women who died or were lost to follow-up prior to their 46th birth date, or had not reached age 46 years as of December 31, 2014 were not included in this analysis. Follow-up for these analyses was started at age 46 years.
e Women who were taking systemic ET (only oral or transdermal) on their 50th birth date, after bilateral oophorectomy. Women who died or were lost to follow-up prior to their 50th birth date, or had not reached age 50 years as of December 31, 2014 were not included in this analysis. Follow-up for these analyses was started at age 50 years.
f The benign condition (eg, cysts, endometriosis) was listed by the gynecologist in the medical record at the time of oophorectomy, but may not have been the sole indication for the surgery.
g Women without a benign ovarian condition. Historically, the terms “prophylactic”, “elective”, or “incidental” oophorectomy were used; however, we prefer to avoid these terms.
