title: A systematic review of prognostic factors for return to work following work-related traumatic hand injury.
abstract: METHODS
  Systematic review.
  
  
  BACKGROUND
  Traumatic hand injuries are frequent cause of work related injuries and can result in prolonged durations of time loss from work.
  
  
  OBJECTIVE
  To systematically review available evidence to determine which prognostic factors predict return-to-work (RTW) following work-related traumatic hand injuries.
  
  
  METHODS
  We searched Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL and PsycINFO from 1980 to September 2013 and reference lists of articles. Studies investigating any prognostic factors of RTW after traumatic hand injury were included. Two reviewers performed study selection, assessment of methodological quality and data extraction independently of each other. Identified factors were grouped into conceptual prognostic factor categories.
  
  
  RESULTS
  We assessed 8 studies, which addressed 11 potential prognostic factors (i.e., sociodemographic factors, occupation, work compensation status, treatment related factors, impairment severity, location of injury, etc.). The quality of the studies was low to moderate. Across all included studies, RTW (original or modified work) occurred in over 60% of individuals by 6 months. There was consistent low-moderate quality evidence that individuals with more severe impairments and lower pre-injury income were less likely to RTW, and low-moderate quality evidence that age, gender and level of education had no impact on RTW. Evidence on other commonly cited prognostic factors were limited in the literature.
  
  
  CONCLUSIONS
  Impairment severity and lower pre-injury income showed a consistent association with RTW following occupational hand injury, while other factors demonstrated no or variable effects across studies. Additional high-quality studies are warranted toward improving our understanding of the complex factors that mediate RTW following a traumatic work-related hand injury.
  
  
  METHODS
  2a.
authors.affiliation: Health & Rehabilitation Sciences, Western University, Elborn College, Room 1014, 1201 Western Road, London, Ontario, Canada N6G 1H1; Hand and Upper Limb Centre Clinical Research Laboratory, St. Joseph's Health Centre, 268 Grosvenor St., London, Ontario, Canada N6A 3A8. Electronic address: qshi26@uwo.ca.
authors.forename: Qiyun
authors.initials: Q
authors.lastname: Shi
authors.affiliation: School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada L8S 4L8.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Sinden
authors.affiliation: Health & Rehabilitation Sciences, Western University, Elborn College, Room 1014, 1201 Western Road, London, Ontario, Canada N6G 1H1; Hand and Upper Limb Centre Clinical Research Laboratory, St. Joseph's Health Centre, 268 Grosvenor St., London, Ontario, Canada N6A 3A8; School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada L8S 4L8.
authors.forename: Joy C
authors.initials: JC
authors.lastname: MacDermid
authors.affiliation: Health & Rehabilitation Sciences, Western University, Elborn College, Room 1014, 1201 Western Road, London, Ontario, Canada N6G 1H1.
authors.forename: David
authors.initials: D
authors.lastname: Walton
authors.affiliation: Hand and Upper Limb Centre Clinical Research Laboratory, St. Joseph's Health Centre, 268 Grosvenor St., London, Ontario, Canada N6A 3A8.
authors.forename: Ruby
authors.initials: R
authors.lastname: Grewal
mesh_terms: D000062:Accidents, Occupational; D000367:Age Factors; D004522:Educational Status; D006230:Hand Injuries / Q000628:therapy*; D006304:Health Status; D006801:Humans; D007182:Income; D015601:Injury Severity Score; D008603:Mental Health; D009790:Occupations; D011379:Prognosis; D062707:Return to Work; D012737:Sex Factors; D014942:Workers' Compensation
keywords: Hand injury; Return to work; Systematic review; Trauma; Work-related