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Serum creatine kinase associated with poor outcomes after forearm fasciotomy

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Philip E. Blazar

LAS VEGAS — Patients who underwent forearm fasciotomy for treatment of acute compartment syndrome experienced poor outcomes when they had elevated serum creatine kinase, according to results presented at the American Society for Surgery of the Hand Annual Meeting.

Among 130 patients with acute forearm compartment syndrome who underwent forearm fasciotomy, Philip E. Blazar, MD, and colleagues found poor outcomes for 43 patients, including five patient deaths, five patients who underwent limb amputation of the upper extremity, 21 persistent neurologic deficits and 31 contractures.

“When we did our initial bivariate analysis, we identified BMI, the mechanism of injury, serum potassium and hemoglobin levels and creatine kinase were associated with poor outcomes as a result,” Blazar said in his presentation here.

He added multivariate logistic regression analysis showed creatine kinase was associated with poor outcomes. Serum creatine kinase greater than 300 U/L was a sensitive predictor for poor outcomes, according to Blazar, who said, it “may be a useful screening test in certain situations where the diagnosis is somewhat unclear for patients who are at the highest risk for forearm compartment syndrome.”

Blazar also noted having a serum creatine kinase level greater than 10,000 U/L was a specific predictor for poor outcomes.

“Certainly, at this point, I think we can suggest that this is a valuable adjunct in terms of the informed consent process for patients in this scenario and, certainly regarding a prognosis, this may be helpful in predicting patients [with] a relatively high probability of a poor outcome in this scenario,” Blazar said. – by Casey Tingle

Reference:

Blazar PE, et al. Abstract 40. Presented at: American Society for Surgery of the Hand Annual Meeting; Sept. 5-7, 2019; Las Vegas.

Disclosure: Blazar reports no relevant financial disclosures.