Predictors of functional outcome after peripheral nerve injury and compression.

STUDY

DESIGN

Retrospective cohort study.

INTRODUCTION

Upper-extremity peripheral nerve injuries can impact long-term pain, work performance, and disability, yet there are few studies evaluating treatment outcomes for a large sample of patients with varying peripheral nerve pathology.

PURPOSE OF THE STUDY: The purpose of this study was to identify outcomes of care and predictors of disability and health status in adults with peripheral nerve injuries.

METHODS

We explored medical records from 364 patients treated by a plastic surgeon over a three-year period. Descriptive and inferential statistics compared the Disabilities of the Arm, Shoulder, and Hand, Short-Form 8, and routine intake data between baseline and discharge, diagnosis, and intervention group. Multivariate linear regression models predicted disability, work disability, and physical and mental health at discharge.

RESULTS

We found significant improvements in disability, work disability, pain, depression, and stress. Health status changed minimally. Disability decreased most in patients who were working and who had symptoms fewer than six months. Outcomes were not statistically different between surgical and nonsurgical patients. Disability was the highest in patients with brachial plexus injuries. Multivariate models predicted 35 to 55% of the variance in the outcome measures. Factors that were highly predictive of functional outcomes included work status, household management, pain, depression, stress, and difficulty sleeping.

CONCLUSIONS

Patients with peripheral nerve injuries experience improved pain and disability whether treated surgically or nonsurgically. Maintaining engagement in meaningful home and work roles may improve outcomes. Helping patients manage pain remains important, along with combatting stress, depression, and sleep deprivation.