A prognostic model for the risk of development of upper extremity compartment syndrome in the setting of brachial artery injury.
A potentially devastating sequela of brachial artery injury in the setting of upper extremity trauma is the development of compartment syndrome (CS). We performed a retrospective review of 139 trauma patients with brachial artery injury from 1985-2001. Objective characteristics of each case were extracted and analyzed using multivariate logistic regression. Three variables were found to be significant in the final model: estimated intraoperative blood loss as a continuous variable, and presence of a multiple arterial injury and presence of an open fracture as categorical variables. Odds ratio were 1.12, 5.79, and 2.68, respectively. We used these variables to create a summative score for the development of CS with weights assigned proportional to the adjusted odds ratio. Odds of having CS for subjects in group 2 and group 3 are 5.3 and 15.1 times the odds for subjects in group 1, respectively. Applying multivariate regression analysis to the largest series of brachial artery injuries to date, we have developed a predictive scoring model of CS.
Kim
John Y S
JY
Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA. jokim@nmh.org
Schierle
Clark F
CF
Subramanian
Vairavan S
VS
Birman
Michael V
MV
Kloeters
Oliver
O
Forte
Antonio J V
AJ
Basu
C Bob
CB
Wall
Matthew J
MJ
Epstein
Michael
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000098:blood supply*; D001916:Brachial Artery / Q000293:injuries*; D002648:Child; D003161:Compartment Syndromes / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult