Background Cochin Hand Function Score(CHFS) is a questionnaire proposed and validated by Poole JL et al(Arthritis Rheum 2004; 51:805-9), to measure the disability due to hand involvement in Systemic Sclerosis(SSc) patients. It includes 18 items, refering to personal hygiene, dressing, cooking, occupation and other tasks.
Objectives To assess the CHFS applicability in spanish SSc patients, as well as its correlation with some clinical features, measurements and specific disease questionnaires.
Methods Multicentric, descriptive and cross-sectional study with analytic components. SSc patients from two hospitals were assessed regarding hand disability by means of the CHFS. This questionnaire had previously been translated and adaptated to Spanish. Clinical assessment was simultaneously performed, and the next data were collected: age, time since SSc diagnosis, modified Rodnan skin score(mRSS), mRSS of fingers and hands, finger flexion and extension, digital ischemic ulcers(DIU), digital necrosis, amputations, calcinosis, tendon contractures and joint swelling of the hands. Global disability was assessed by the sHAQ and VAS of Raynaud(VAS-FRy) and DIU(VAS-DIU). In each hospital, patients were always evaluated by the same expert rheumatologist. SPSS Statistics 17.0 was used for data analysis, and percentages, means(SD) and medians(range) were assessed for describing variables. Pearson’s test was used to assess the correlation between CHFS and quantitative variables, and Spearman’s coefficient for the correlation between CHFS and qualitative variables, interpreted as excellent(>0.8), good(0.6-0.8), moderate(0.4-0.6), and poor(<0.4).
Results A total of 56 patients were evaluated (51 female, 5 male; 40 lSSc, 16 dSSc; age and disease duration: 52±15, 11±9 years; 23% with DIU; 21% with joint swelling of the hands; 18% with finger contractures; 16% with hand calcinosis; 9% with digital necrosis; 2% with previous finger amputation). Mean total CHFS was 16.1 (dSSc:25.2, lSSc:12.2). Correlation between disease duration and total CHFS was good (r: 0.70), as well as it was with scores of its different domains, with the exception of “other tasks” (r: 0.48). Correlation between CHFS and total mRSS, mRSS of fingers, digital flexion, necrosis, calcinosis and joint contractures was only moderate, but it was good with hands’ mRSS, SHAQ, and both VAS (r: 0.678, 0.677, 0.619 and 0.7, respectively). When correlations were assessed separately for each type of SSc, it happened to be a very good correlation between CHFS and mRSS of the hands, SHAQ and both VAS (r: 0.82, 0.87, 0.89 and 0.93, respectively) in dSSc patientes. However, correlations between CHFS and mRSS were moderate or even poor in lSSc (though it was kept good for the SHAQ, r: 0.72).
Conclusions The Spanish version of the CHFS is useful in spanish SSc patients, and mainly assesses hand disability related to the degree of skin involvement, specially in dSSc patients. A complete method of validation is needed to confirm these previous results.
Disclosure of Interest None Declared