Department of Emergency Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang-si 10326, Republic of Korea.
Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu 41566, Republic of Korea.
Medicina (Kaunas). 2024 Jan 5;60(1):105. doi: 10.3390/medicina60010105.
This study aimed to analyze patients with rhabdomyolysis who presented to emergency departments and identify their distribution of related disease and prognostic factors. A retrospective cohort study was conducted on patients with rhabdomyolysis who presented to emergency departments over a 10-year period. Patient data, including patients' demographic variables (sex and age), mode of arrival, final diagnosis, statin use, rhabdomyolysis trigger factors, and levels of serum creatine phosphokinase (CPK), myoglobin, creatinine, sodium, potassium, phosphate, calcium, and lactate, were analyzed. Univariate and multivariate logistic regression analyses were conducted to identify the predictive factors of acute kidney injury (AKI). Among the patients, 268 (65.6%) were found to have trigger factors without underlying diseases. Furthermore, 115 (28.2%) patients developed AKI. This comprehensive study sheds light on the diverse factors influencing the occurrence of AKI in rhabdomyolysis and provides insights into AKI predictive markers. Furthermore, we analyzed the cases by dividing them into six groups: occurrence of AKI, occurrence of infection, and simple or complex rhabdomyolysis. CPK time course was found to be important in clinical prognosis, such as AKI occurrence, dialysis or not, and mortality. Age, statin use, elevated creatinine and lactate levels, and initial serum CPK level emerged as significant predictors of AKI. CPK time course was also found to be an important factor in predicting the clinical outcomes of patients with rhabdomyolysis.
本研究旨在分析因横纹肌溶解症就诊于急诊科的患者,并确定其相关疾病的分布和预后因素。采用回顾性队列研究方法,对 10 年间因横纹肌溶解症就诊于急诊科的患者进行研究。分析患者数据,包括患者的人口统计学变量(性别和年龄)、就诊方式、最终诊断、他汀类药物使用情况、横纹肌溶解症的诱因以及血清肌酸磷酸激酶(CPK)、肌红蛋白、肌酐、钠、钾、磷、钙和乳酸水平。采用单因素和多因素逻辑回归分析来确定急性肾损伤(AKI)的预测因素。在这些患者中,268 例(65.6%)存在无基础疾病的诱因。此外,115 例(28.2%)患者发生 AKI。这项综合研究揭示了影响横纹肌溶解症患者发生 AKI 的多种因素,并为 AKI 预测标志物提供了新的认识。此外,我们还将病例分为六组:发生 AKI、发生感染、单纯或复杂横纹肌溶解症进行分析。CPK 时间进程在临床预后方面非常重要,如 AKI 的发生、是否需要透析以及死亡率。年龄、他汀类药物使用、肌酐和乳酸水平升高以及初始血清 CPK 水平是 AKI 的显著预测因素。CPK 时间进程也是预测横纹肌溶解症患者临床结局的重要因素。