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CoSy (Compartment Syndrome) Score of Trew et al for Predicting Outcome After Fasciotomy for Chronic Exertional Compartment Syndrome (CECS)

Description

Trew et al reported a simple score for predicting outcome following fasciotomy performed for chronic exertional compartment syndrome (CECS). This CoSy (Compartment Syndrome) score can help to identify an athlete who is more likely to return to sport after fasciotomy. The authors are from Royal United Hospitals in Bath.


Patient selection: chronic exertional compartment syndrome

 

Exercise protocol: brisk walking for 10 minutes (600 seconds) followed by rest

 

Parameters:

(1) area under the curve (AUC) of the intraexcercise intracompartment pressure (ICP) in mm Hg•s^2

(2) peak intraexercise intracompartment pressure (ICP) in mm Hg

(3) history of CECS pain

(4) gradient in intraexcercise intracompartmental pressure (ICP) in mm Hg

(5) duration of symptoms with rest in minutes

 

Parameter

Finding

Points

area under the curve

<= 22,000 mm Hg•s^2

0

 

> 22,000 mm Hg•s^2

2

peak intraexercise ICP

<= 40 mm Hg

0

 

> 40 mm Hg

2

history of CECS pain

no

0

 

yes

1

gradient intraexercise ICP

<= 10 mm Hg

0

 

> 10 mm Hg

1

symptom duration at rest

< 30 minutes

1

 

>= 30 minutes

0

 

total score =

= SUM(points for all of the parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 7

• A score >= 4 is associated with a high level of sports participation after fasciotomy (89%).

• A score < 4 is associated with a low level of sports participation after fasciotomy (20%).


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