Predictive Factors for Post-Ischemic Compartment Syndrome in Non-Traumatic Acute Limb Ischemia in a Lower Extremity

Abstract

Objective: Compartment syndrome (CS) is serious complication following revascularization of acute limb ischemia (ALI). However, predictive factors associated with CS remain unclear. This study aimed to identify these predictive factors.

Materials and Methods: Twenty-two patients who presented with non-traumatic ALI between November 2013 and October 2015 were enrolled and monitored for CS in this prospective cohort study. Predictive factors were compared between the CS and non-CS groups.

Results: There were 5 patients in the CS group and 17 patients in the non-CS group. Four predictive factors were associated with CS: (1) inadequate backflow (80% and 12% in the CS and non-CS groups, respectively; P=.001); (2) serum creatine kinase (CK) level (20,683 U/L and 911 U/L in the CS and non-CS groups, respectively; P<.001); (3) positive fluid balance after admission (4,324 mL and 1,223 mL in the CS and non-CS groups, respectively; P<.001); and (4) Rutherford category IIB (100% and 18% in the CS and non-CS groups, respectively; P=.0002).

Conclusion: Inadequate backflow, high serum CK level, positive fluid balance, and advanced-stage ALI were associated with CS. This information may be useful in identification of high-risk patients for CS prevention and in early detection of CS following the revascularization procedure.