Evaluation of Obesity and Age as a Predictive Factor of Lower Extremity Compartment Syndrome: A National Trauma Data Bank Analysis

Background Risk factors of acute compartment syndrome (ACS) of the leg include tibial fractures followed by soft tissue injuries. Methods Data collected from the National Trauma Data Bank (NTDB) between 2017-2019 were analyzed for adult patients with lower extremity fractures, including proximal tibia, tibial shaft, and distal tibia. The primary outcome was a diagnosis of ACS. Results There were 1,052/220,868 patients with lower extremity fractures with a concomitant diagnosis of compartment syndrome. Our study has shown that patients with a BMI of ≥ 30 had a lower incidence of compartment syndrome when compared with patients with a BMI of 25-29 and controlled for fracture type. Increased age ≥ 55 in males, and females between 65-84, also demonstrated a decreased risk. Proximal tibial fractures (n=54,696) were significantly associated with ACS compared to midshaft (n=42,153) and distal (n=100,432), p<0.0001. Conclusion We found that being overweight decreases risk for development of compartment syndrome in patients with lower extremity fractures. This big data study aids in establishing risk factors for development of ACS in adult trauma patients.