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Risk Factors for Compartment Syndrome in Pediatric Trauma Patients
Jennifer A Sees, MPH1, 2, Gretchen J Cutler, PhD2, MPH, Henry W Ortega, MD2. 1University of Minnesota, Minneapolis, MN,USA, 2Children's Minnesota, Minneapolis, MN, USA.

Background: There a lack of research on compartment syndrome (CS) and risk factors in pediatric trauma populations.

Methods: We included patients less than 19 years of age treated at trauma centers contributing to the National Trauma Data Bank between 2009 and 2012. Multivariable logistic regression was used to examine the association between risk factors and the development of CS. The final model adjusted for age, sex, race, number of comorbidities, Glascow Coma Scale, Injury Severity Score, mechanism of injury and fracture of the lower limb.

Results: A total of 341,238 patients were eligible for analysis, and 896 patients developed CS (0.3%). In adjusted regression models, older patients had significantly higher odds of CS compared to patients aged 1 or less (OR= 3.29, 95% CI: 1.29 8.37 (2-6 years);OR= 7.55, 95% CI: 3.08 18.55 (7-12 years); OR= 10.34, 95% CI: 4.26 25.09 (13-18 years). Males had significantly increased odds of CS compared to females, as did patients with fractures of the lower limb compared to patients without lower limb fractures (OR 1.93, 95% CI: 1.56 2.40; OR 7.61, 95% CI 6.48 8.94; respectively). Finally, patients with a firearm injury had higher odds of CS compared to other mechanisms of injury (OR 3.51, CI 95% 2.70 4.56).

Conclusions: Older pediatric trauma patients, males, and those with lower limb fractures and firearm injuries have increased odds of CS. Information on risk factors can be used to help identify patients most likely to develop CS to facilitate timely diagnosis and treatment.

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