Dawes Donald M, Ho Jeffrey D, Sweeney James D, Lundin Erik J, Kunz Sebastian N, Miner James R
University of Louisville, Louisville, KY, USA.
Forensic Sci Med Pathol. 2011 Mar;7(1):3-8. doi: 10.1007/s12024-010-9187-4. Epub 2010 Aug 4.
The medical literature on the effect of electronic control devices (ECD) on muscle injury is sparse. In this paper, we examine pooled data from five human studies that used creatine kinase (CK) as a marker for muscle injury. CK was measured in five separate studies involving four TASER ECDs with different exposure durations and number of circuits or contact points. Device type, exposure duration, number of circuits or contact points, and CK values at baseline and 24 h after exposure were pooled from these previous studies. Data were analyzed to determine the correlation of CK to duration of exposure, number of contact points, and distance between the probes. The pooled results contained 163 subjects. Seven were withdrawn due to incomplete data, leaving 156 subjects for analysis (median age 36, range 19-67, 93.6% male). 121 (77.6%) subjects had 2 contacts points, 10 (6.4%) had 3 contact points, 18 (11.5%) had 4 contact points, and 7 (4.5%) had 6 contact points. 81 (51.9%) subjects had a 5-s exposure, 64 (41.0%) a 10-s exposure, and, 11 (7.1%) a 30-s exposure. Median baseline CK (145 U/l, IQR 104-217, range 12-1956) did not differ between groups (P = 0.213 for number of contact points, 0.124 for duration). For the number of contacts, the median change in CK for 2 points of contact was 32 (IQR -1 to 1513, range -205 to 1821), for 3 was 1456 (IQR 634-1868, range 101-25452), for 4 was 887 (IQR 285-7481, range -1054 to 7481), and for 6 was 846 (IQR 57-1149, range -8 to 2309), (P < 0.001). For duration, the median change in CK for 5 s was 26.5 (IQR -8 to 109, range -1054 to 2309), for 10 s was 303 (IQR 34.5-1073, range -205 to 25452), and for 30 s was 47 (IQR 23-82, range -140 to 364), (P < 0.001). There was a relationship between the number of points of contact and the change in CK (P < 0.001) but not a relationship between the duration and the change in CK (P = 0.496). The median spread between the probe pairs for our pooled data was 40 cm, with a range from 18 to 70 cm (n = 76). The correlation between the change in CK and spread between the probe pairs was 0.16 at baseline (P = 0.18), and 0.24 at 24 h (P = 0.04) by Spearman's rank correlation. ECD exposure can cause a modest increase in CK. Although we cannot draw conclusions about the individual devices included in this analysis, our findings indicated that multiple contact points or exposures may result in a larger increase in CK, but the duration of the exposure does not appear to have a significant effect on CK. There is a correlation between the distance between the probes and the change in CK.
关于电子控制设备(ECD)对肌肉损伤影响的医学文献较为稀少。在本文中,我们研究了五项人体研究的汇总数据,这些研究使用肌酸激酶(CK)作为肌肉损伤的标志物。在五项独立研究中测量了CK,这些研究涉及四种不同暴露持续时间以及不同电路或接触点数量的泰瑟ECD。从这些先前的研究中汇总了设备类型、暴露持续时间、电路或接触点数量以及暴露前和暴露后24小时的CK值。对数据进行分析以确定CK与暴露持续时间、接触点数量和探头之间距离的相关性。汇总结果包含163名受试者。7名因数据不完整而被排除,剩下156名受试者进行分析(中位年龄36岁,范围19 - 67岁,93.6%为男性)。121名(77.6%)受试者有2个接触点,10名(6.4%)有3个接触点,18名(11.5%)有4个接触点,7名(4.5%)有6个接触点。81名(51.9%)受试者暴露5秒,64名(41.0%)暴露10秒,11名(7.1%)暴露30秒。各组之间的中位基线CK(145 U/l,IQR 104 - 217,范围12 - 1956)无差异(接触点数量P = 0.213,暴露持续时间P = 0.124)。对于接触点数量,2个接触点时CK的中位变化为32(IQR -1至1513,范围 -205至1821);3个接触点时为1456(IQR 634 - 1868,范围101至25452);4个接触点时为887(IQR 285 - 7481),范围 -1054至7481);6个接触点时为846(IQR 57 - 1149范围 -8至2309),(P < 0.001)。对于暴露持续时间,5秒时CK的中位变化为26.5(IQR -8至109范围 -1054至2309);10秒时为303(IQR 34.5 - 1073范围 -205至25452);30秒时为47(IQR 23 - 82范围 -140至364),(P < 0.001)。接触点数量与CK变化之间存在关系(P < 0.001),但暴露持续时间与CK变化之间不存在关系(P = 0.496)。我们汇总数据中探头对之间的中位间距为40厘米,范围为18至70厘米(n = 76)。根据Spearman等级相关性,基线时CK变化与探头对之间间距的相关性为0.16(P = 0.18),24小时时为0.24(P = 0.04)。ECD暴露可导致CK适度升高。虽然我们无法就本分析中所包含的各个设备得出结论,但我们的研究结果表明,多个接触点或暴露可能导致CK升高幅度更大,但暴露持续时间似乎对CK没有显著影响。探头之间的距离与CK变化之间存在相关性。