ArticleJournal of orthopaedic surgery and research2024
Predictors of amputation in patients with acute compartment syndrome after tibial fracture: a nomogram prediction model.
Article in Journal of orthopaedic surgery and research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Unraveling the risk factors, prognostic predictors, and evolving therapeutic approaches for phlegmasia cerulea dolens over 30 years.Annals of medicine · 2025Article
- Development and validation of a nomogram for predicting fasciotomy requirement in lower extremity arterial injuries: a retrospective case-control study.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2025Article
- Review
- Predicting Infection Risk in Acute Compartment Syndrome: A Nomogram Model Based on Admission Blood Indicators.International journal of general medicine · 2025Article
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3 authors.
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Abstract
purposesAmputation is a serious complication in patients with acute compartment syndrome (ACS). However, it risk factors are still poorly understood. Our study aims to investigate the risk factors of amputation in patients with ACS.
methodsWe reviewed the data on ACS patients with tibial fractures from January 2010 to November 2022. Patients with amputation was grouped into the amputation group (AG) and those without amputation was grouped into non-amputation group (NG). We used univariate analysis, logistic regression analysis and nomogram prediction model to analyze the predictors of amputation.
resultsThe rate of amputation was 8.8% (12 of 136) in our study. Crush injury (p = 0.047), heavy object injury (p = 0.045), the presence of blisters (p<0.0001), the number of debridements (p = 0.022), muscle necrosis (p = 0.004), deep venous thrombosis (DVT, p<0.0001), the level of osmotic pressure (p = 0.003) after fasciotomy were found to be associated with amputation in ACS patients by univariate analysis. Logistic regression analysis showed that crush injury [p = 0.036, OR = 16.403, 95% CI (1.198, 224.609)], heavy object injury [p = 0.010, OR = 50.751, 95% CI (2.577, 999.490)], muscle necrosis [p = 0.017, OR = 17.272, 95% CI (1.666, 179.102)], and DVT [p = 0.009, OR = 22.344, 95% CI (2.146, 232.589)] were risk factors of amputation. Then, we constructed a nomogram prediction model with 0.9066 in AUC of the prediction model with good consistency in the correction curve and good clinical practicality by decision curve analysis.
conclusionsWe identified crush injury, heavy object injury, muscle necrosis, and DVT as independent risk factors for amputation in ACS patients. Our nomogram prediction model can availably predict amputation in ACS patients. Additionally, we found that the timing of fasciotomy is not associated with amputation in ACS patients. LEVEL OF EVIDENCE: Level III.
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