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评估肥胖和年龄作为下肢间隔综合征的预测因素:国家创伤数据库分析。

Evaluation of obesity and age as a predictive factor of lower extremity compartment syndrome: A national trauma data bank analysis.

机构信息

Eastern Virginia Medical School, Norfolk, VA, USA.

Penn State College of Medicine, M.S. Hershey Medical Center, Hershey, PA, USA.

出版信息

Am J Surg. 2024 Aug;234:129-135. doi: 10.1016/j.amjsurg.2024.04.013. Epub 2024 Apr 16.

Abstract

BACKGROUND

Risk factors of acute compartment syndrome (ACS) of the leg include tibial fractures followed by soft tissue injuries.

METHODS

Data collected from the National Trauma Data Bank (NTDB) between 2017 and 2019 were analyzed for adult patients with lower extremity fractures, including proximal tibia, tibial shaft, and distal tibia. The primary outcome was a diagnosis of ACS.

RESULTS

There were 1052/220,868 patients with lower extremity fractures with a concomitant diagnosis of compartment syndrome. Our study has shown that patients with a BMI of ≥30 had a lower incidence of compartment syndrome when compared with patients with a BMI of 25-29 and controlled for fracture type. Increased age ≥55 in males, and females between 65 and 84, also demonstrated a decreased risk. Proximal tibial fractures (n ​= ​54,696) were significantly associated with ACS compared to midshaft (n ​= ​42,153) and distal (n ​= ​100,432), p ​< ​0.0001.

CONCLUSION

We found that being overweight decreases risk for development of compartment syndrome in patients with lower extremity fractures. This big data study aids in establishing risk factors for development of ACS in adult trauma patients.

摘要

背景

腿部急性骨筋膜室综合征(ACS)的风险因素包括胫骨骨折后伴软组织损伤。

方法

分析 2017 年至 2019 年期间国家创伤数据库(NTDB)中成人下肢骨折患者的数据,包括胫骨近端、胫骨骨干和胫骨远端。主要结局是 ACS 的诊断。

结果

在 220868 例下肢骨折患者中,有 1052 例并发筋膜间室综合征。我们的研究表明,与 BMI 为 25-29 的患者相比,BMI≥30 的患者发生筋膜间室综合征的发生率较低,并且控制了骨折类型。男性年龄≥55 岁,女性年龄在 65 岁至 84 岁之间,也显示出较低的风险。胫骨近端骨折(n=54696)与骨干中段(n=42153)和远端(n=100432)相比,与 ACS 显著相关,p<0.0001。

结论

我们发现超重会降低下肢骨折患者发生筋膜间室综合征的风险。这项大数据研究有助于确定成人创伤患者 ACS 发展的危险因素。

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