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Workers' compensation status: does it affect orthopaedic surgery outcomes? A meta-analysis.

Vinícius Ynoe de Moraes1, Katelyn Godin, Marcel Jun Sugawara Tamaoki

  • 1Division of Hand and Upper Limb Surgery, Department of Orthopaedics and Trauma, Universidade Federal de São Paulo, São Paulo, Brazil. vymoraes@gmail.com

Plos One
|December 11, 2012
PubMed
Summary

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Patients receiving Workers' Compensation have double the risk of negative outcomes after orthopaedic surgery. This meta-analysis provides a more accurate risk estimate than previous reviews, highlighting the need for further research.

Area of Science:

  • Orthopaedic Surgery
  • Health Economics
  • Patient Outcomes

Background:

  • Previous reviews indicate Workers' Compensation influences orthopaedic surgery outcomes.
  • Methodological variability in prior studies may have skewed association strength.
  • This meta-analysis aims to precisely evaluate Workers' Compensation impact on surgical results.

Purpose of the Study:

  • To systematically assess the influence of Workers' Compensation on patient outcomes following orthopaedic surgery.
  • To provide a more accurate risk estimation by analyzing prospective studies.
  • To identify potential etiological explanations for compensation status effects.

Main Methods:

  • Systematic literature search (1992-2012) across multiple databases (MEDLINE, Embase, CINAHL, etc.).

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  • Inclusion of prospective studies on adult orthopaedic patients with or without compensation.
  • Outcomes measured included quality of life scales and surgeon judgment; data analyzed using Review Manager.

    • Main Results:

    • Twenty studies met eligibility criteria.
    • Patients with Workers' Compensation showed a 2.08 times higher risk of unsatisfactory orthopaedic surgery outcomes (95% CI 1.54-2.82).
    • A significant negative association was found for quality of life measures (SMD = -0.70, 95% CI -0.97- -0.43).

    Conclusions:

    • Workers' Compensation recipients face a doubled risk of adverse outcomes post-orthopaedic surgery.
    • This study's risk estimate is lower than prior reviews using retrospective data.
    • Further research is needed to understand the causal mechanisms linking compensation status to surgical outcomes.