From the Departments of Plastic, Reconstructive, and Hand Surgery, Rehabilitation Medicine, Biostatistics, and Public Health, Erasmus University Medical Centre; the Hand and Wrist Centre, Xpert Clinic; and the Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Center.
Plast Reconstr Surg. 2021 Sep 1;148(3):580-590. doi: 10.1097/PRS.0000000000008224.
Return to work is potentially an important factor in assessing the success of treatment. However, little is known about the return to work after treatment for Dupuytren's contracture. Therefore, the primary aim of this study was to assess return to work after limited fasciectomy and percutaneous needle fasciotomy.
Patients who underwent either a limited fasciectomy or percutaneous needle fasciotomy were invited to complete a return-to-work questionnaire at 6 weeks, 3 months, 6 months, and 12 months postoperatively. Median time to return to work was assessed using inverted Kaplan-Meier curves, and hazard ratios were calculated with Cox regression models. Finally, a cost analysis was carried out using the human capital method to determine indirect costs associated with loss of productivity.
The authors included 2698 patients in the study, of which 53 percent were employed at intake and included in the follow-up. After 1 year of follow-up, 90 percent of the patients had returned to work. Median time to return to work was 2 weeks after limited fasciectomy and within days after percutaneous needle fasciotomy. Furthermore, physically strenuous work, female sex, and higher age were associated with a longer time to return to work. Lost productivity per patient was estimated at €2614.43.
The majority of patients returned to work after treatment for Dupuytren's disease. Return to work is much faster after percutaneous needle fasciotomy compared to limited fasciectomy. These findings can be used for more evidence-based preoperative counseling with patients with Dupuytren's disease.
重返工作岗位可能是评估治疗成功的一个重要因素。然而,对于掌腱膜挛缩症治疗后的重返工作岗位情况,我们知之甚少。因此,本研究的主要目的是评估局限性掌腱膜切除术和经皮针刀松解术后的重返工作岗位情况。
邀请接受局限性掌腱膜切除术或经皮针刀松解术的患者在术后 6 周、3 个月、6 个月和 12 个月时完成一份重返工作岗位问卷。使用倒置 Kaplan-Meier 曲线评估重返工作岗位的中位时间,并使用 Cox 回归模型计算危险比。最后,采用人力资本法进行成本分析,以确定与生产力损失相关的间接成本。
本研究共纳入 2698 例患者,其中 53%的患者在入组时就业并纳入随访。在 1 年的随访后,90%的患者已重返工作岗位。局限性掌腱膜切除术的中位重返工作时间为 2 周,经皮针刀松解术的中位重返工作时间为数天。此外,体力劳动、女性和较高年龄与重返工作岗位的时间延长相关。每位患者的生产力损失估计为 2614.43 欧元。
大多数患者在接受掌腱膜挛缩症治疗后重返工作岗位。与局限性掌腱膜切除术相比,经皮针刀松解术后重返工作岗位的速度更快。这些发现可用于为掌腱膜挛缩症患者提供更具循证医学依据的术前咨询。