Predictors of blisters in patients with acute compartment syndrome

Abstract

Introduction: Blisters, one of the most common complications of orthopedic trauma, can result in surgery delay and increase the risk of infection. This study aimed to identify the risk factors for blisters in patients with acute compartment syndrome (ACS). Methods: We gathered data from two hospitals' 206 ACS patients from November 2013 to January 2021. Patients were divided into the blister group (BG) and the control group (CG) according to whether they had blisters or not. We used univariate analysis, logistic regression analysis, and receiver operating characteristic (ROC) curve analysis to determine the demographics, comorbidities, and admission laboratory tests. Results: In our research, the incidence of blisters was 21.8 % (45 of 206). Univariate analysis showed that numerous factors were releated to the formation of blisters. According to logistic regression analysis, patients who developed ACS in the winter or spring (p = 0.007, OR = 2.690, 95% CI (1.308 to 5.534), patients who received a referral (p = 0.009, OR = 4.235, 95% CI (1.432 to 12.527), and patients with higher PLR (p = 0.036, OR = 1.005, 95% CI (1.000 to 1.009) were independent risk factors for blisters. In addition, a history of drinking (p = 0.039, OR = 0.027, 95% CI (0.046 to 0.927)) represented a protective factor for the formation of blisters in these patients. ROC curve analysis revealed that 138.17 was the cut-off value of PLR to predict the blister. Furthermore, the combination of seasonal factors, PLR, and referral had the highest diagnostic accuracy. Conclusions: Our findings identified seasonal factors, referral, and patients with higher PLR as independent risk factors while a history of drinking as protective factor for blisters in ACS patients, allowing us to individualize the evaluation of the risk of blisters in order to perform early targeted therapies.