Department of Translational Medicine - Hand Surgery, Lund University, Lund, Sweden.
Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden.
BMJ Open. 2023 Dec 14;13(12):e077101. doi: 10.1136/bmjopen-2023-077101.
OBJECTIVES: To investigate if socioeconomic status impacts patient-reported outcomes after a surgically treated trigger finger (TF). DESIGN AND SETTING: Data on patients with TF treated with surgery were collected from the Swedish National Quality Registry of Hand Surgery (HAKIR) 2010-2019 with an evaluation of symptoms and disability before surgery and at 3 and 12 months after surgery, using the short version of the Disabilities of Arm, Shoulder and Hand (QuickDASH) questionnaire.Data from HAKIR and the Swedish National Diabetes Registry (ndr.nu) were combined with socioeconomic data from Statistics Sweden (scb.sc), analysing the impact of marital status, education level, income, occupation, sickness benefits, days of unemployment, social assistance and migrant status on the outcome by a linear regression model. PARTICIPANTS: In total, 5477 patients were operated on for primary TF during the study period, of whom 21% had diabetes, with a response rate of 35% preoperatively, 26% at 3 months and 25% at 12 months. RESULTS: At all time points, being born in Sweden (preoperatively B-coefficient: -9.74 (95% CI -13.38 to -6.11), 3 months postoperatively -9.80 (95% CI -13.82 to -5.78) and 12 months postoperatively -8.28 (95% CI -12.51 to -4.05); all p<0.001) and high earnings (preoperatively -7.81 (95% CI -11.50 to -4.12), 3 months postoperatively -9.35 (95% CI -13.30 to -5.40) and 12 months postoperatively -10.25 (95% CI -14.37 to -6.13); all p<0.0001) predicted lower QuickDASH scores (ie, fewer symptoms and disability) in the linear regression models. More sick leave during the surgery year predicted higher QuickDASH scores (preoperatively 5.77 (95% CI 3.28 to 8.25; p<0.001), 3 months postoperatively 4.40 (95% CI 1.59 to 7.22; p<0.001) and 12 months postoperatively 4.38 (95% CI 1.35 to 7.40; p=0.005)). No socioeconomic factors impacted the change in QuickDASH score from preoperative to 12 months postoperatively in the fully adjusted model. CONCLUSION: Individuals with low earnings, high sick leave the same year as the surgery and those born outside of Sweden reported more symptoms both before and after surgery, but the relative improvement was not affected by socioeconomic factors.
目的：探讨社会经济地位是否影响接受手术治疗的扳机指（TF）患者的患者报告结局。
设计和设置：从瑞典手部外科国家质量登记处（HAKIR）2010-2019 年收集接受手术治疗的 TF 患者的数据，在术前以及术后 3 个月和 12 个月时使用手臂、肩部和手部残疾问卷（QuickDASH）的简表评估症状和残疾。将 HAKIR 和瑞典国家糖尿病登记处（ndr.nu）的数据与瑞典统计局（scb.sc）的社会经济数据相结合，通过线性回归模型分析婚姻状况、教育程度、收入、职业、病假津贴、失业天数、社会救助和移民身份对结果的影响。
参与者：在研究期间，共有 5477 名患者因原发性 TF 接受手术治疗，其中 21%患有糖尿病，术前应答率为 35%，术后 3 个月时为 26%，术后 12 个月时为 25%。
结果：在所有时间点，在瑞典出生（术前 B 系数：-9.74（95%CI-13.38 至-6.11），术后 3 个月-9.80（95%CI-13.82 至-5.78），术后 12 个月-8.28（95%CI-12.51 至-4.05）；均<0.001）和高收入（术前-7.81（95%CI-11.50 至-4.12），术后 3 个月-9.35（95%CI-13.30 至-5.40），术后 12 个月-10.25（95%CI-14.37 至-6.13）；均<0.0001）预测 QuickDASH 评分（即症状和残疾程度）较低。手术当年的病假天数越多，QuickDASH 评分越高（术前 5.77（95%CI 3.28 至 8.25；<0.001），术后 3 个月 4.40（95%CI 1.59 至 7.22；<0.001），术后 12 个月 4.38（95%CI 1.35 至 7.40；p=0.005））。在完全调整的模型中，没有社会经济因素影响从术前到术后 12 个月 QuickDASH 评分的变化。
结论：低收入、当年高病假以及在瑞典境外出生的个体报告术前和术后症状更多，但相对改善程度不受社会经济因素影响。
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