腕管松解术或桡骨远端骨折切开复位内固定术前后的出勤率和缺勤率

Q3 Medicine

Journal of Hand Surgery Global Online Pub Date : 2024-11-01 DOI:10.1016/j.jhsg.2024.08.009

David N. Bernstein MD, PhD , Alexy Ilchuk BA , Monica M. Shoji MD , Carl M. Harper MD , Tamara D. Rozental MD

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引用次数: 0

摘要

目的手的使用对一个人能否成功工作至关重要。手部病变会增加缺勤率（即无法上班）和旷工率（即能够上班但工作能力下降），从而影响工作的成功率。在这项研究中，我们量化了就业患者在腕管松解术或桡骨远端骨折（DRF）手术固定后的旷工和缺勤情况。方法在这项前瞻性队列研究中，纳入了 2022 年 6 月至 2023 年 12 月期间的 91 名患者（腕管综合征 [CTS]：n = 62；DRF：n = 29）。研究收集了患者的基线特征和患者报告的结果指标（PROMs）。采用世界卫生组织的健康和工作表现问卷计算出缺勤率和旷工率。在手术前、手术后 3 个月和 6 个月进行问卷调查。采用最小临床意义差异（MCID）临界范围估算法确定临床改善情况。结果在所有功能和疼痛相关的PROMs中，手术前和手术后6个月PROMs评分的平均变化超过了MCID估计值的低端。结论接受 CTS 或 DRF 手术的患者在术后 6 个月时，其功能和疼痛症状在临床上有明显改善。然而，与 DRF 手术固定相比，腕管松解术后 6 个月，员工价值的恢复超过了完全恢复，而 DRF 手术固定术后，员工价值的损失超过了 40%。这些发现有助于术前期望值的设定。

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Presenteeism and Absenteeism Before and After Carpal Tunnel Release or Open Reduction and Internal Fixation for Distal Radius Fracture

Purpose

The use of a person’s hands is crucial to their ability to succeed at work. Hand pathologies can impact work success by increasing absenteeism (ie, not being able to go to work) and presenteeism (ie, being able to work but in a reduced capacity). In this study, we quantified employed patients’ presenteeism and absenteeism following carpal tunnel release or surgical fixation of a distal radius fracture (DRF).

Methods

In this prospective cohort study, 91 patients (carpal tunnel syndrome [CTS]: n = 62; DRF: n = 29) from June 2022 to December 2023 were included. Baseline patient characteristics and patient-reported outcome measures (PROMs) were collected. Presenteeism and absenteeism were calculated using the World Health Organization’s Health and Work Performance Questionnaire. Questionnaires were sought before surgery and at 3 and 6 months after surgery. Clinical improvement was determined using minimal clinically important difference (MCID) cutoff range estimates. The employee value of lost work was calculated as a percentage of the average patient in each group before surgery and at 6 months after surgery.

Results

The average change in PROMs scores from before to after surgery at 6 months surpassed the low-end MCID estimates for all functional and pain-related PROMs. For patients undergoing surgery for CTS and DRF, retained employee value rose from 85.6% to 130.2% (ie, worked more than expected) and 52.7% to 56.9%, respectively.

Conclusions

Patients undergoing surgery for CTS or DRF have clinically appreciable improvement in functional and pain symptoms by 6 months after surgery. However, by 6 months after surgery, carpal tunnel release results in greater than complete employee value recovery, compared with surgical fixation of DRFs in which greater than 40% of the employee value remains lost after surgery. These findings can assist with preoperative expectation setting.