Compartment syndrome is associated with acute kidney injury following revascularisation in patients with lower extremity arterial occlusive disease: a retrospective cohort study.

چکیده اصلی

BACKGROUND: Compartment syndrome (CS) is a severe complication after revascularisation for lower extremity arterial occlusive disease (LEAOD), but its association with systemic complications remains unclear. METHODS: This single-center retrospective cohort study included 153 patients with LEAOD who underwent revascularisation between January 2020 and December 2025. Postoperative CS was the primary exposure, and patients were classified into CS and non-CS groups. Clinical outcomes, including final amputation and acute kidney injury (AKI), were compared using multivariable logistic regression. RESULTS: CS occurred in 29 patients (19.0%). Patients with CS showed more severe ischemia and metabolic disturbance. The CS group had a higher crude final amputation rate than the non-CS group, but CS was not independently associated with final amputation after adjustment (OR 1.56; 95% CI 0.27-8.97; p = 0.618). AKI occurred more frequently in the CS group (69.0 vs. 12.1%, p < 0.001), and CS remained strongly associated with AKI after adjustment (OR 20.94; 95% CI 5.62-78.10; p < 0.001), with consistent findings in sensitivity analyses. Among patients with both CS and AKI, CS preceded AKI in all cases. CONCLUSIONS: Postoperative CS may represent a clinically recognizable marker of severe ischemia-reperfusion injury and systemic injury burden associated with AKI, rather than a definitive causal determinant of AKI or limb loss.

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