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

Jonathan J Light; Jana M Davis; Jackie Dunahoe; Dustin Stwalley; Anna N Miller; Lisa K Cannada

doi:10.1016/j.amjsurg.2024.04.013

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

Am J Surg. 2024 Apr 16:S0002-9610(24)00230-7. doi: 10.1016/j.amjsurg.2024.04.013. Online ahead of print.

Authors

Jonathan J Light¹, Jana M Davis², Jackie Dunahoe³, Dustin Stwalley⁴, Anna N Miller³, Lisa K Cannada⁵

Affiliations

¹ Eastern Virginia Medical School, Norfolk, VA, USA.
² Penn State College of Medicine, M.S. Hershey Medical Center, Hershey, PA, USA.
³ Washington University Department of Orthopaedic Surgery, St. Louis, MO, USA.
⁴ Washington University Institute for Informatics, Data Sciences and Biostatistics, St. Louis, MO, USA.
⁵ Novant Health Orthopaedic Fracture Clinic, University of North Carolina School of Medicine, Charlotte Campus, Charlotte, NC, USA. Electronic address: cannada.lisa@gmail.com.

PMID: 38653707
DOI: 10.1016/j.amjsurg.2024.04.013

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.

Keywords: Acute care; Acute compartment syndrome; Body mass index; Gender; Orthopaedic trauma; Risk factors.