Assessment of POPSAVEIT in lower extremity vascular injuries in Zagazig University

Abstract

Background: Traumatic injury of popliteal artery records the highest risk of lower extremity loss with amputation rates of 10% to 15%. A method to investigate the predictors of amputation is needed because previous scores could not be validated. The goal of this review is to investigate if POPSAVEIT (popliteal scoring assessment for vascular extremity injuries in trauma) may be used as a preoperative indicator of amputation risk in patients with traumatic injury of popliteal vessel.

Methods: From 2017 to 2022, all patients who underwent surgical repair of popliteal arterial traumatic injuries at Zagazig University Hospitals were included in this retrospective study. Patients who needed amputation were assessed to those with limb salvage. Based on univariate analysis, the significant predictors of POPSAVEIT variables for amputation were included in a multivariable analysis. To determine low vs. high-risk scores, receiver operating characteristic (ROC)curve are created.

Results: 76 patients were included in the study, with an overall amputation rate of 18.4%. The following risk factors were shown to be independently related with amputation: systolic blood pressure <90 mm Hg (OR, 5.3; P = 0.05), associated orthopedic injury (OR, 6.1; P = 0.009), and a lack of preoperative pedal Doppler signals (OR, 8.3; P = 0.001). For a high risk of amputation, a score of ≥3 was determined to have the best sensitivity (78.6%) and specificity (59%).

Conclusions: POPSAVEIT is a preoperative simple and practical way to classify patients into low- and high-risk major amputation categories.