Acute compartment syndrome (ACS) is an emergency orthopaedic condition wherein a rapid rise in compartmental pressure compromises blood perfusion to the tissues leading to ischaemia and muscle necrosis. This serious condition is often misdiagnosed or associated with significant diagnostic delay, and can lead to limb amputations and death.

The most common causes of ACS are high impact trauma, especially fractures of the lower limbs which account for 40% of ACS cases. ACS is a challenge to diagnose and treat effectively, with differing clinical thresholds being utilised which can result in unnecessary osteotomy. The highly granular data for over 800 patients with ACS provide the following key parameters to support critical research into this condition:

1) Patient data (injury type, location, age, sex, pain levels, pre-injury status and comorbidities) 2) Physiological parameters (intracompartmental pressure, pH, tissue oxygenation, compartment hardness) 3) Muscle biomarkers (creatine kinase, myoglobin, lactate dehydrogenase) 4) Blood vessel damage biomarkers (glycocalyx shedding markers, endothelial permeability markers)

PIONEER geography: The West Midlands (WM) has a population of 5.9 million & includes a diverse ethnic & socio-economic mix.

UHB is one of the largest NHS Trusts in England, providing direct acute services & specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds & an expanded 250 ITU bed capacity during COVID. UHB runs a fully electronic healthcare record (EHR) (PICS Birmingham Systems), a shared primary & secondary care record (Your Care Connected) & a patient portal “My Health”.

Scope: Enabling data-driven research and machine learning models towards improving the diagnosis of Acute compartment syndrome. Longitudinal & individually linked, so that the preceding & subsequent health journey can be mapped & healthcare utilisation prior to & after admission understood. The dataset includes highly granular patient demographics, physiological parameters, muscle biomarkers, blood biomarkers and co-morbidities taken from ICD-10 & SNOMED-CT codes. Serial, structured data pertaining to process of care (timings and admissions), presenting complaint, lab analysis results (creatinine, eGFR, troponin, CRP, INR, ABG glucose), systolic and diastolic blood pressures, procedures and surgery details.

Available supplementary data: Matched controls ambulance, OMOP data, synthetic data.

Available supplementary support: Analytics, Model build, validation & refinement A.I. Data partner support for ETL (extract, transform & load) process, Clinical expertise, Patient & end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen” services.