The initial anatomical severity in patients with hand injuries predicts future health-related quality of life

Background: 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. Methods: 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. Results: 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. Conclusions: 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.