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%.
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general