The Initial Anatomical Severity in Patients With Hand Injuries Predicts Future Health-Related Quality of Life

Abstract

There have been no rigorous studies exploring whether the severity of hand injury can predict health-related quality of life (HRQoL). The purpose of our study is to examine the relationship between the initial anatomic severity of hand injuries (evaluated by the Hand Injury Severity Scoring [HISS] system) and HRQoL in patients with hand injuries. Patients with hand injuries hospitalized for surgery between 2004 and 2008 were recruited and HISS scores were calculated by a hand surgeon. One hundred seventy-three patients were interviewed for demographic information and HRQoL status. The physical and mental component summaries of HRQoL were compared with the initial HISS scores by multiple regression models. The greater the HISS score, the lower the score of the physical component of HRQoL. Trend tests showed a significant correlation between the physical component of HRQoL in the dominant hand injured group (p = 0.04), but not in the nondominant hand injured group (p = 0.49). With regard to age, trend tests showed a significant correlation between the physical component of HRQoL in older patients (p < 0.01) but not in younger patients (p = 0.40). For all outcomes of mental component scores, we found no significant relationship with HISS severity in neither main effects nor stratified analyses. HISS is able to predict the physical HRQoL with useful levels of accuracy. It is strongly recommended that surgical therapy departments provide more detailed physiotherapy programs for the high-risk groups, such as dominant hand injury and age of ≥40, to improve their physical HRQoL.