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Model of Valdez et al for Predicting Compartment Syndrome in a Lower Extremity Following Trauma

Description

Valdez et al studied factors associated with a compartment syndrome developing in a lower extremity following trauma. These can help to identify a patient who may benefit from more aggressive management. The authors are from George Washington University in Washington, D.C.


 

Patient selection: lower extremity trauma (most with fracture of tibia and/or fibula)

 

Parameters:

(1) maximum serum CK concentration

(2) maximum serum chloride concentration

(3) minimum serum BUN concentration

 

Parameter

Finding

Points

maximum serum CK

<= 4,000 IU/L

0

 

> 4,000 IU/L

1

maximum serum chloride

<= 104 mmol/L

0

 

> 104 mmol/L

1

minimum serum BUN

< 10 mg/dL

1

 

>= 10 mg/dL

0

 

total score =

= SUM(points for all 3 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 3

• The higher the score the greater the probability of a compartment syndrome in the extremity.

 

Total Score

Percent with Compartment Syndrome

0

0%

1

36%

2

80%

3

100%

 

Performance:

• With a cutoff of >= 2, the sensitivity was 85% and specificity 87%.

 


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