Citation

Lee YY, Chang JH, Shieh SJ, Lee YC, Kuo LC, Lee YL. J. Trauma 2010; 69(6): E88-93.

Affiliation

Bureau of Food and Drug Analysis, Department of Health, Executive Yuan, Taipei, Taiwan; Department of Occupational Therapy, National Cheng Kung University, Tainan, Taiwan; Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Medical Center, Tainan, Taiwan; Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.

Copyright

(Copyright © 2010, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0b013e3181cf7b38

PMID

20489670

Abstract

BACKGROUND:: The severity of the injury is the most important factor to return to work (RTW) when it comes to hand injuries. The purpose of our study is to examine the relationship between the initial anatomic severity, evaluated by the Hand Injury Severity Scoring (HISS) system, and probability of RTW in occupational hand injured patients. METHODS:: In this retrospective cohort study, 140 patients hospitalized for surgery due to occupational hand injuries between 2004 and 2008 were recruited. Participants were interviewed for occupational history and RTW status. The probability of RTW was compared with the initial HISS scores by multiple logistic regression models. RESULTS:: In workers' compensation group, there was a significant relationship between HISS severity and the probability of RTW. Compensated patients with moderate injuries (odds ratio OR. = 0.15; 95% confidence interval CI., 0.03-0.70) and severe injuries (OR = 0.13; 95% CI, 0.02-0.75) were significantly less likely to RTW than those with minor injuries, and those with major injuries were the least likely to RTW (OR = 0.07; 95% CI, 0.01-0.36). However, no association was found between HISS severity and the probability of RTW for patients without workers' compensation. With regard to the HISS components, patients with motor or neural component deficits had a significantly lower opportunity of RTW, with the neural deficits being the most influential. CONCLUSION:: HISS is a useful instrument to predict the opportunity of RTW while restricted to the compensated patients. We also verified that the relationship between HISS severity and the probability of RTW existed for groups but not for individual patients.

Language: en