Association between the initial anatomical severity and opportunity of return to work in occupational hand injured patients.
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.


CONCLUSIONS
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.
Lee
Yung-Yi
YY
Bureau of Food and Drug Analysis, Department of Health, Executive Yuan, Taipei, Taiwan.
Chang
Jer-Hao
JH
Shieh
Shyh-Jou
SJ
Lee
Yao-Chou
YC
Kuo
Li-Chieh
LC
Lee
Yungling L
YL
D000062:Accidents, Occupational; D000293:Adolescent; D000328:Adult; D004185:Disability Evaluation; D004651:Employment; D005260:Female; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies