A prognostic model for the risk of development of upper extremity compartment syndrome in the setting of brachial artery injury

John Y S Kim, Clark F. Schierle, Vairavan S. Subramanian, Michael V. Birman, Oliver Kloeters, Antonio J V Forte, C. Bob Basu, Matthew J. Wall, Michael Epstein

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

A potentially devastating sequela of brachial artery injury in the setting of upper extremity trauma is the development of compartment syndrome (CS). We performed a retrospective review of 139 trauma patients with brachial artery injury from 1985-2001. Objective characteristics of each case were extracted and analyzed using multivariate logistic regression. Three variables were found to be significant in the final model: estimated intraoperative blood loss as a continuous variable, and presence of a multiple arterial injury and presence of an open fracture as categorical variables. Odds ratio were 1.12, 5.79, and 2.68, respectively. We used these variables to create a summative score for the development of CS with weights assigned proportional to the adjusted odds ratio. Odds of having CS for subjects in group 2 and group 3 are 5.3 and 15.1 times the odds for subjects in group 1, respectively. Applying multivariate regression analysis to the largest series of brachial artery injuries to date, we have developed a predictive scoring model of CS.

Original languageEnglish (US)
Pages (from-to)22-27
Number of pages6
JournalAnnals of plastic surgery
Volume62
Issue number1
DOIs
StatePublished - Jan 1 2009

Keywords

  • Brachial artery
  • Compartment syndrome
  • Fasciotomy
  • Multivariate logistic regression
  • Vascular injury

ASJC Scopus subject areas

  • Surgery

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