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Risk reduction of long-term major adverse cardiovascular events after endoscopic thoracic sympathectomy in palmar hyperhidrosis

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A Correction to this article was published on 02 June 2018

This article has been updated

Abstract

Purpose

Palmar hyperhidrosis (PH) is excessive sweating of the palms resulting from sympathetic overactivity, and patients who undergo endoscopic thoracic sympathectomy (ETS) show reduced cardiac demand after 1 year and improved cerebral perfusion within 2–4 weeks. However, the long-term risks of major adverse cardiovascular events (MACE) following ETS remain unclear.

Methods

We searched the Longitudinal National Health Insurance Database in Taiwan and identified PH patients (International Classification of Disease, Ninth Revision, Clinical Modification diagnostic code 708.8) from the outpatient database and patients who underwent ETS (procedure code 05.29) from the inpatient database between 2000 and 2010; furthermore, we excluded patients younger than 18 years of age or older than 65 years of age. We defined MACE as stroke (diagnostic codes 430–437), myocardial infarction (diagnostic code 410), or death. Patients followed until the first cardiac event or December 31, 2010. Risk factors were identified using a multivariable Cox proportional hazards regression.

Results

The incidence of MACE was significantly lower in patients with ETS (0.76%) than without (1.67%). In PH patients, ETS significantly reduced the risk of MACE (adjusted hazard ratio 0.473; 95% confidence interval 0.277–0.808).

Conclusion

PH patients who underwent ETS showed a reduced risk of MACE over a long-term follow-up period. This result could provide support for patients with PH who are considering undergoing ETS because of its additional cardiovascular benefits.

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Change history

  • 02 June 2018

    There is a typographical error in the International Classification of Disease Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic code used for palmar hyperhidrosis. The published manuscript wrongly reports that the ICD-9-CM code used for palmar hyperhidrosis was 708.8 (which indicates a diagnosis of “Other specified urticaria”), when, in actuality, the correct code 780.8 (“Hyperhidrosis”) was applied. The authors regret this typographical error.

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Acknowledgements

The authors thank the Ministry of Science and Technology, Republic of China (MOST 105-2221-E-038-008), and Tri-Service General Hospital (TSGH-C105-003, TSGH-C106-002) for support.

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Author notes

  1. Hung-Wen Chiu and Wu-Chien Chien contributed equally for correspondence purposes.

Authors and Affiliations

  1. Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

    Chun-An Cheng & Hsin Chu

  2. Graduate Institute of Biomedical Informatics, Taipei Medical University, No. 250, Wu-Hsing Street, 110, Taipei, Taiwan

    Chun-An Cheng & Hung-Wen Chiu

  3. Department of Emergency, Armed Taoyuan General Hospital, Taoyuan, Taiwan

    Chun-Gu Cheng

  4. Department of Emergency and Critical Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan

    Chun-Gu Cheng

  5. Graduate Institute of Aerospace and Undersea Medicine, National Defense Medical Center, Taipei, Taiwan

    Hsin Chu

  6. Aviation Physiology Research Laboratory, Gangshan Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan

    Hsin Chu

  7. Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

    Hung-Che Lin

  8. Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No.325, Section 2, Cheng-Kung Road, Neihu District, Taipei City, 11490, Taiwan, ROC

    Chi-Hsiang Chung & Wu-Chien Chien

  9. School of Public Health, National Defense Medical Center, Taipei, Taiwan

    Chi-Hsiang Chung & Wu-Chien Chien

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  1. Chun-An Cheng
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Correspondence to Hung-Wen Chiu or Wu-Chien Chien.

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Cheng, CA., Cheng, CG., Chu, H. et al. Risk reduction of long-term major adverse cardiovascular events after endoscopic thoracic sympathectomy in palmar hyperhidrosis. Clin Auton Res 27, 393–400 (2017). https://doi.org/10.1007/s10286-017-0464-0

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  • DOI: https://doi.org/10.1007/s10286-017-0464-0

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