Abstract
Purpose:
The primary aim of this study was to investigate the risk factors associated with the bad outcomes of acute compartment syndrome (ACS) of lower leg. The secondary objective was to determine if delayed fasciotomy is linked to bad outcomes.
Methods:
In a retrospective study approved by the institutional review board, we identified 103 patients with ACS of lower leg. Among these, 44 patients exhibited bad outcome while 59 patients demonstrated a good outcome. Patient-related factors, laboratory values, and treatment-related factors were analyzed using electronic medical records. Univariate statistical and logistic regression analyses were conducted to determine significance.
Results:
Bivariate analyses showed that the mechanism of injury (P = 0.021), open injury (P = 0.001), arterial injury (P<0.001), HB (P < 0.001), WBC (P = 0.008), ALB (P<0.001), CK at presentation (P = 0.015), peak CK (P<0.001), Ca (P = 0.004), dehydrating agent (P = 0.036), and debridement (P = 0.005) were found to be associated with the risk of poor outcomes. Logistic regression analyses revealed that arterial injury [p < 0.001, OR = 66.172, 95% CI (10.536, 415.611)] was an independent risk factor for poor outcomes. However, HB [p = 0.005, OR = 0.934, 95% CI (0.891, 0.979)] was a protective factor against poor outcomes.
Conclusions:
ACS of the lower leg is a serious complication often associated with a poor prognosis. Patients with arterial injury or lower HB have a significantly increased risk of having poor outcomes. Poor outcomes were not found to be associated with the timing of fasciotomy in this study.