Perfusion Pressure Lacks Diagnostic Specificity for the Diagnosis of Acute Compartment Syndrome

Objective: To evaluate the diagnostic performance of perfusion pressure (PP) thresholds for fasciotomy. Design: Prospective observational study. Setting: Seven Level-1 trauma centers. Patients/Participants: One hundred fifty adults with severe leg injuries and ≥2 hours of continuous PP data who had been enrolled in a multicenter observational trial designed to develop a clinical prediction rule for acute compartment syndrome (ACS). Main Outcome Measurements: For each patient, a given PP criterion was positive if it was below the specified threshold for at least 2 consecutive hours. The diagnostic performance of PP thresholds between 10 and 30 mm Hg was determined using 2 reference standards for comparison: (1) the likelihood of ACS as determined by an expert panel who reviewed each patient's data portfolio or (2) whether the patient underwent fasciotomy. Results: Using the likelihood of ACS as the diagnostic standard (ACS considered present if median likelihood ≥70%, absent if
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research