Postoperative extremity compartment syndrome in a cancer center: Incidence and risk factors Journal Article
| Authors: | Vaynrub, M.; Or, O.; Drill, E.; Saulan, M.; Boland, P. J. |
| Article Title: | Postoperative extremity compartment syndrome in a cancer center: Incidence and risk factors |
| Abstract: | Objective: Postoperative compartment syndrome is a reported complication with known patient- and treatment-specific risk factors. Cancer patients carry unique risk factors associated with their underlying disease and long, complex procedures. While elevated serum lactate in traumatic and intensive care settings portends higher risk, no laboratory parameter has demonstrated utility in postoperative risk stratification. Postoperative extremity compartment syndrome in the study institution's cancer population was examined and whether intraoperative serum lactate correlates with postoperative compartment syndrome risk was investigated. Methods: A 1:2 case-control study was performed, which compared cancer patients with postoperative compartment syndrome to those who underwent similar surgical procedures without this complication. Twelve patients were matched to 24 controls by sex, age, surgical procedures, and duration of surgery. Patient and operative variables were analyzed for prognostic significance. Results: The compartment syndrome rate was 0.09% of all cases (n = 13,491); 0.12% of cases ≥ 3 h’ duration (n = 9,979), and 0.25% of cases ≥ 5 h (n = 4,811). Compared with controls, the case group had higher median BMI (31.7 kg/m2 vs. 25.4 kg/m2, P = 0.001), and median intraoperative lactate level (4.05 mmol/L vs. 1.5 mmol/L, P = 0.047). Conclusion: Our institutional incidence of postoperative compartment syndrome was similar to that of non-oncologic institutions. While many traditional risk factors did not prove to be influential in our patients, elevated median body mass index and intraoperative serum lactate were identified as risk factors for postoperative compartment syndrome in a cancer population. © 2021 Elsevier Ltd |
| Keywords: | adult; clinical article; controlled study; cancer surgery; case control study; plastic surgery; cancer patient; peripheral neuropathy; incidence; medical record review; oncology; risk factor; risk assessment; postoperative complication; postoperative complications; cancer center; operation duration; compartment syndrome; disease predisposition; thorax surgery; breast surgery; lactic acid; lactate blood level; preoperative chemotherapy; pediatric surgery; human; male; female; priority journal; article; manometry; fasciotomy; lithotomy position |
| Journal Title: | Surgical Oncology |
| Volume: | 38 |
| ISSN: | 0960-7404 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2021-09-01 |
| Start Page: | 101563 |
| Language: | English |
| DOI: | 10.1016/j.suronc.2021.101563 |
| PROVIDER: | scopus |
| PUBMED: | 33857839 |
| PMCID: | PMC8429058 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 May 2021 -- Source: Scopus |
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