Department of Translational Medicine-Hand Surgery, Lund University, Skåne University Hospital, Jan Waldenströms Gata 5, 205 02, Malmö, Sweden.
Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden.
Sci Rep. 2024 Mar 27;14(1):7242. doi: 10.1038/s41598-024-57757-w.
Peripheral nerve injuries in the upper limb can lead to substantial disability and pain. We aimed to assess how socioeconomic factors affect outcomes after repaired or reconstructed digital or major nerve trunk injuries in the upper limb. We identified 670 individuals, who underwent surgical nerve repair or reconstruction using sensory nerve autografts, in the Swedish National Quality Registry for Hand Surgery 2010-2018. Socioeconomic factors, including education, cohabitation, type of work, sick leave, immigrant status and income, were gathered from the Swedish statistical agency ( www.scb.se ) and National Diabetes Register (NDR). We calculated prevalence ratios (PR) to assess the relationship between socioeconomic factors and surgical outcomes for the nerve injuries. Individuals with a major nerve trunk injury had higher QuickDASH scores and lower income compared to those with digital nerve injury. Individuals with immigration background (adjusted PR = 2.0, 95% CI 1.2-3.2), history of > 4 weeks of sick leave the year before surgery (adjusted PR = 1.8, 95% CI 1.1-3.1), or education level below tertiary (adjusted PR = 2.8, 95% CI 1.7-4.7) had significantly higher QuickDASH scores. Recognizing impact of non-biological factors, including immigration, prior sick leave, and education level, on outcome after nerve surgery is crucial for improving prognosis in socioeconomically deprived individuals.
上肢周围神经损伤可导致严重残疾和疼痛。我们旨在评估社会经济因素如何影响上肢修复或重建后的数字或主要神经干损伤的结果。我们在 2010 年至 2018 年期间,从瑞典手部手术国家质量登记处确定了 670 名接受感觉神经自体移植的手术神经修复或重建的个体。社会经济因素包括教育程度、同居情况、工作类型、病假、移民身份和收入,这些因素均从瑞典统计局(www.scb.se)和国家糖尿病登记处(NDR)收集。我们计算了患病率比(PR),以评估社会经济因素与神经损伤手术结果之间的关系。与数字神经损伤相比,主要神经干损伤患者的 QuickDASH 评分更高,收入更低。具有移民背景的个体(调整后的 PR=2.0,95%CI 1.2-3.2)、手术前一年病假超过 4 周的个体(调整后的 PR=1.8,95%CI 1.1-3.1)或教育程度低于高等教育的个体(调整后的 PR=2.8,95%CI 1.7-4.7)的 QuickDASH 评分明显更高。认识到非生物因素(包括移民、既往病假和教育程度)对神经手术后结果的影响对于改善社会经济弱势群体的预后至关重要。