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A prospective evaluation of the Modified Hand Injury Severity Score in predicting return to work
F Urso-Baiarda1, R A Lyons, J H Laing
1Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, SA6 6NL, UK. fulvio@doctors.org.uk
International Journal of Surgery (London, England)
|November 22, 2007
Summary
The Modified Hand Injury Scoring System (MHISS) accurately predicts return-to-work ability after hand injuries. Higher MHISS scores correlate with longer recovery times, impacting work and financial decisions.
Area of Science:
- Orthopedics
- Occupational Medicine
- Rehabilitation Medicine
Background:
- Hand injuries are a leading cause of work-related disability in young adults.
- Quantifying injury severity is crucial for predicting patient outcomes.
- Existing scoring systems may not fully capture the complexity of hand and forearm injuries.
Purpose of the Study:
- To evaluate the Modified Hand Injury Scoring System (MHISS) for predicting return-to-work ability and time.
- To compare MHISS scores with demographic, injury, and employment factors.
- To establish the prognostic value of MHISS in patients with acute hand or forearm injuries.
Main Methods:
- Prospective cohort study involving patients with acute hand or forearm injuries.
- Modified Hand Injury Scoring System (MHISS) scores were assigned at presentation.
- Data on demographics, injury characteristics, employment, and quality of life were collected 40-52 months post-injury.
- Statistical analysis to identify predictors of return to work.
Main Results:
- The MHISS score was the sole significant predictor of return-to-work ability.
- Median return-to-work time increased from 30 days (Mild MHISS) to 760 days (Major MHISS).
- Factors like age, occupation, injury side, and compensation-seeking did not predict return to work.
Conclusions:
- Injury severity, as quantified by MHISS, is a critical determinant of return to work after hand or forearm injuries.
- Patients with Major MHISS injuries have a lower return-to-work rate (60%) and prolonged recovery (over a year).
- MHISS provides valuable information for patients to make informed financial and retraining decisions post-injury.
