Predictors of muscle necrosis in patients with acute compartment syndrome

Abstract

Purpose The predictors of muscle necrosis after acute compartment syndrome (ACS) remain debated. This study aimed to investigate the predictors for muscle necrosis in ACS patients. Methods We collected data on ACS patients following fractures from January 2010 to November 2022. Patients were divided into the muscle necrosis group (MG) and the non-muscle necrosis group (NG). The demographics, comorbidities, and admission laboratory indicators were computed by univariate analysis, logistic regression analysis, and receiver-operating characteristic (ROC) curve analysis. Results In our study, the rate of MN was 37.6% (83 of 221). Univariate analysis showed that numerous factors were associated with muscle necrosis following ACS. Logistic regression analysis indicated that crush injury ( p = 0.007), neutrophil (NEU, p = 0.001), creatine kinase myocardial band (CKMB, p = 0.047), and prothrombin time (PT, p = 0.031) were risk factors. Additionally, ROC curve analysis identified 11.415 10 9 /L, 116.825 U/L, and 12.51 s as the cut-off values for NEU, CKMB, and PT to predict muscle necrosis, respectively. Furthermore, the combination of NEU, CKMB, and PT had the highest diagnostic accuracy. Conclusions Our findings showed that crush injury and the level of NEU, CKMB, and PT were risk factors for muscle necrosis after ACS. Additionally, we also identified the cut-off values of NEU, CKMB, and PT and found the combination of crush injury, PT, and NEU with the highest diagnostic accuracy, helping us individualize the assessment risk of muscle necrosis to manage early targeted interventions.

Olink proteomics analysis uncovers the landscape of inflammation-related proteins in patients with acute compartment syndrome

“…Acute compartment syndrome (ACS) is a severe orthopedic emergency that affects 1-30.4% of patients with lower extremity fractures, based on previous reports (1)(2)(3). It is characterized by rapidly increased pressure within a closed compartment after trauma, causing bleeding, tissue edema, and reduced limb perfusion.…”

“…A delay in diagnosis or treatment can result in unimaginable outcomes, such as sensory deficits, paralysis, infection, or muscle necrosis (4)(5)(6). Our latest studies have reported that neutrophils (NEU) and creatine kinase myocardial bands (CKMB) may be biomarkers of ACS (2,7). However, there was a limited number of complete blood counts and derived inflammatory indicators.…”