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A Pilot Study to Compare the ESIC Hand Injury Severity Score for Hand Injuries With the Pre-existing Hand Injury
Shashikant Prakash1, Aakash Tomar2, Lokendra Singh3
1Employees' State Insurance Corporation (ESIC), New Delhi, India.
Background:
Hand injuries are a major contributor to emergency department workload and work-related disability. Existing descriptive scoring systems, such as Hand Injury Severity Score (HISS) and Modified HISS, help grade injury severity but have notable limitations. We developed the Employees' State Insurance Corporation Hand Injury Severity Score (ESICHISS), a simple, function-orientated scoring system. The aim was to determine whether this functionally orientated scoring system correlates with injury severity as measured by the descriptive HISS.
Methods:
All hand injury patients presenting to the hospital casualty were assessed at the time of their de novo presentation, and the objective information required to calculate both HISS and ESICHISS was recorded. The Spearman rank correlation test was used to evaluate the association between injury severity as determined by the prospectively assigned ESICHISS and the corresponding HISS scores at presentation. In addition, separate analyses were performed to assess the correlation between the 2 scoring systems specifically for amputational injuries and for integument-only injuries, which represent the 2 extremes of the hand injury spectrum.
Results:
The Spearman rank correlation showed a significant positive association between overall injury severity as assessed by HISS and ESICHISS (P = .024). No correlation was observed for amputational injuries (P = .264) or for integument-only injuries (P = .060). In contrast, a strong and statistically significant correlation was observed for all remaining hand injuries (P = .009).
Conclusion:
Employees' State Insurance Corporation Hand Injury Severity Score provides a more functionally meaningful assessment of hand injury severity compared with the pre-existing HISS. Its use may help patients make earlier and better-informed personal, financial, and retraining decisions following injury.
