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足部急性骨筋膜室综合征的预测因素:大数据分析

Predictors of Foot Acute Compartment Syndrome: Big Data analysis.

作者信息

Laverdiere Carl, Montreuil Julien, Bouklouch Yasser, Lorange Justin-Pierre, Dion Charles-Antoine, Harvey Edward J

机构信息

Department of Orthopedic Surgery, McGill University Health Centre, Montreal, Canada.

Department of Orthopedic Surgery, McGill University Health Centre, Montreal, Canada.

出版信息

J Foot Ankle Surg. 2023 Jan-Feb;62(1):27-30. doi: 10.1053/j.jfas.2022.03.006. Epub 2022 Mar 24.

DOI:10.1053/j.jfas.2022.03.006
PMID:35473922
Abstract

Acute compartment syndrome (ACS) in the foot is a challenging diagnosis and can lead to significant disabilities to patients. The present study aims to investigate the incidence, risk factors, demographics and association in the analysis of acute compartment syndrome (ACS) of the foot. We performed a retrospective review of the Trauma Quality Programs data from the American College of Surgeons including 70,525 patients who sustained a fracture of the foot from 2015 to 2018 (4 calendar years). Fasciotomies were performed in 0.7% of all foot fractures. Open fractures, crush injuries and multiple foot fractures were the strongest predictors of fasciotomies, with odds ratios of 2.38, 2.38 and 2.33 respectively. Being a male was associated with an increased likelihood of fasciotomies of 64% (p < .0001 O.R. = [1.42-1.90]), while a dislocation in the foot increased likelihood of fasciotomies by 48% (p = .0008 O.R. = [1.18-1.86]). Trauma centre level III had higher rate of fasciotomy than Tertiary Trauma centers. Multiple other factors were addressed while controlling for cofounders. This big data analysis provided information not previously reported on the risk factors, demographics, and clinical association of ACS in the foot.

摘要

足部急性骨筋膜室综合征(ACS)的诊断颇具挑战性,可能会给患者带来严重残疾。本研究旨在调查足部急性骨筋膜室综合征(ACS)的发病率、危险因素、人口统计学特征及其相关性。我们对美国外科医师学会创伤质量项目的数据进行了回顾性分析,这些数据涵盖了2015年至2018年(共4个日历年)期间70525例足部骨折患者。在所有足部骨折患者中,0.7%的患者接受了筋膜切开术。开放性骨折、挤压伤和多发性足部骨折是筋膜切开术的最强预测因素,其优势比分别为2.38、2.38和2.33。男性接受筋膜切开术的可能性增加了64%(p <.0001,优势比 = [1.42 - 1.90]),而足部脱位使筋膜切开术的可能性增加了48%(p =.0008,优势比 = [1.18 - 1.86])。三级创伤中心的筋膜切开术发生率高于一级创伤中心。在控制混杂因素的同时,还分析了其他多个因素。这项大数据分析提供了此前未报道过的关于足部急性骨筋膜室综合征的危险因素、人口统计学特征及临床相关性的信息。

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