A predictive nomogram-based model for lower extremity compartment syndrome after trauma in the United States: a retrospective case-control study
Purpose The aim of this study was to utilize the American College of Surgeons Trauma Quality Improvement Program (TQIP) database to identify risk factors associated with developing acute compartment syndrome (ACS) following lower extremity fractures. Specifically, a nomogram of variables was constru...
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Korean Society of Traumatology
2024-06-01
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| Series: | Journal of Trauma and Injury |
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| Online Access: | http://jtraumainj.org/upload/pdf/jti-2023-0077.pdf |
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| author | Blake Callahan Darwin Ang Huazhi Liu |
| author_facet | Blake Callahan Darwin Ang Huazhi Liu |
| author_sort | Blake Callahan |
| collection | DOAJ |
| description | Purpose The aim of this study was to utilize the American College of Surgeons Trauma Quality Improvement Program (TQIP) database to identify risk factors associated with developing acute compartment syndrome (ACS) following lower extremity fractures. Specifically, a nomogram of variables was constructed in order to propose a risk calculator for ACS following lower extremity trauma. Methods A large retrospective case-control study was conducted using the TQIP database to identify risk factors associated with developing ACS following lower extremity fractures. Multivariable regression was used to identify significant risk factors and subsequently, these variables were implemented in a nomogram to develop a predictive model for developing ACS. Results Novel risk factors identified include venous thromboembolism prophylaxis type particularly unfractionated heparin (odds ratio [OR], 2.67; 95% confidence interval [CI], 2.33–3.05; P<0.001), blood product transfusions (blood per unit: OR 1.13 [95% CI, 1.09–1.18], P<0.001; platelets per unit: OR 1.16 [95% CI, 1.09–1.24], P<0.001; cryoprecipitate per unit: OR 1.13 [95% CI, 1.09–1.22], P=0.003). Conclusions This study provides evidence to believe that heparin use and blood product transfusions may be additional risk factors to evaluate when considering methods of risk stratification of lower extremity ACS. We propose a risk calculator using previously elucidated risk factors, as well as the risk factors demonstrated in this study. Our nomogram-based risk calculator is a tool that will aid in screening for high-risk patients for ACS and help in clinical decision-making. |
| format | Article |
| id | doaj-art-068d25e7e282461f94d1c805689b8072 |
| institution | Kabale University |
| issn | 2799-4317 2287-1683 |
| language | English |
| publishDate | 2024-06-01 |
| publisher | Korean Society of Traumatology |
| record_format | Article |
| series | Journal of Trauma and Injury |
| spelling | doaj-art-068d25e7e282461f94d1c805689b80722025-01-16T06:10:17ZengKorean Society of TraumatologyJournal of Trauma and Injury2799-43172287-16832024-06-0137212413110.20408/jti.2023.00771307A predictive nomogram-based model for lower extremity compartment syndrome after trauma in the United States: a retrospective case-control studyBlake Callahan0Darwin Ang1Huazhi Liu2 Department of Surgery, University of Central Florida College of Medicine, Orlando, FL, USA Department of Surgery, University of Central Florida College of Medicine, Orlando, FL, USA Department of Surgery, HCA Ocala Hospital, Ocala, FL, USAPurpose The aim of this study was to utilize the American College of Surgeons Trauma Quality Improvement Program (TQIP) database to identify risk factors associated with developing acute compartment syndrome (ACS) following lower extremity fractures. Specifically, a nomogram of variables was constructed in order to propose a risk calculator for ACS following lower extremity trauma. Methods A large retrospective case-control study was conducted using the TQIP database to identify risk factors associated with developing ACS following lower extremity fractures. Multivariable regression was used to identify significant risk factors and subsequently, these variables were implemented in a nomogram to develop a predictive model for developing ACS. Results Novel risk factors identified include venous thromboembolism prophylaxis type particularly unfractionated heparin (odds ratio [OR], 2.67; 95% confidence interval [CI], 2.33–3.05; P<0.001), blood product transfusions (blood per unit: OR 1.13 [95% CI, 1.09–1.18], P<0.001; platelets per unit: OR 1.16 [95% CI, 1.09–1.24], P<0.001; cryoprecipitate per unit: OR 1.13 [95% CI, 1.09–1.22], P=0.003). Conclusions This study provides evidence to believe that heparin use and blood product transfusions may be additional risk factors to evaluate when considering methods of risk stratification of lower extremity ACS. We propose a risk calculator using previously elucidated risk factors, as well as the risk factors demonstrated in this study. Our nomogram-based risk calculator is a tool that will aid in screening for high-risk patients for ACS and help in clinical decision-making.http://jtraumainj.org/upload/pdf/jti-2023-0077.pdfcompartment syndromeswounds and injuriesextremitiesclinical decision-making |
| spellingShingle | Blake Callahan Darwin Ang Huazhi Liu A predictive nomogram-based model for lower extremity compartment syndrome after trauma in the United States: a retrospective case-control study Journal of Trauma and Injury compartment syndromes wounds and injuries extremities clinical decision-making |
| title | A predictive nomogram-based model for lower extremity compartment syndrome after trauma in the United States: a retrospective case-control study |
| title_full | A predictive nomogram-based model for lower extremity compartment syndrome after trauma in the United States: a retrospective case-control study |
| title_fullStr | A predictive nomogram-based model for lower extremity compartment syndrome after trauma in the United States: a retrospective case-control study |
| title_full_unstemmed | A predictive nomogram-based model for lower extremity compartment syndrome after trauma in the United States: a retrospective case-control study |
| title_short | A predictive nomogram-based model for lower extremity compartment syndrome after trauma in the United States: a retrospective case-control study |
| title_sort | predictive nomogram based model for lower extremity compartment syndrome after trauma in the united states a retrospective case control study |
| topic | compartment syndromes wounds and injuries extremities clinical decision-making |
| url | http://jtraumainj.org/upload/pdf/jti-2023-0077.pdf |
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