Wang Zhen, Wang Qing, Chen Jinghan, Cai Leiming
Department of Nephrology, Shanghai Baoshan District Wusong Central Hospital (Wusong Branch, Zhongshan Hospital Affiliated to Fudan University), Shanghai, 200940, China.
Intensive Care Unit, Shanghai Baoshan District Wusong Central Hospital (Wusong Branch, Zhongshan Hospital Affiliated to Fudan University), Shanghai, 200940, China.
BMC Anesthesiol. 2025 Feb 19;25(1):84. doi: 10.1186/s12871-025-02964-9.
Rhabdomyolysis is commonly encountered in intensive care unit (ICU), yet its clinical features and prognostic indicators have not been comprehensively defined. This study aims to identify clinical characteristics and outcomes of ICU patients with rhabdomyolysis, and assess if rhabdomyolysis predicts outcomes.
This retrospective study investigated patients admitted to the ICU of Shanghai Baoshan District Wusong Central Hospital from 2022 to 2023. Clinical and laboratory indices, along with discharge outcomes, were analyzed.
The study included 151 patients, divided into Control group (CK ≤ 1000 U/L, n = 117) and RML group (CK > 1000 U/L, n = 34) groups. The RML group showed higher proportions of male gender (76.5% vs. 56.4%, p = 0.035), infection (88.2% vs. 68.4%, p = 0.022), muscle weakness (41.2% vs. 13.7%, p = 0.035), and myoglobin > 1000 U/L (55.9% vs. 14.5%, p < 0.001), but lower incidence of malignant tumors (0% vs. 17.9%, p = 0.017). The poor outcome rate (POR, the combined rate of death and cessation of treatment) was significantly higher in the RML group (52.9% vs. 33.3%, p = 0.038). Multivariate logistic regression analysis identified male gender [OR, 1.120-7.147; p = 0.028], sepsis [OR, 1.234-10.949; p = 0.019], and mechanical ventilation [OR, 1.489-8.478; p = 0.004] as independent risk factors for poor outcome in ICU patients. Rhabdomyolysis was not an independent risk factor.
ICU patients with rhabdomyolysis experienced a significantly higher rate of poor outcomes. Male gender, sepsis, and mechanical ventilation were identified as independent risk factors for poor outcomes, while rhabdomyolysis itself was not found to be an independent risk factor. Prospective research is needed to validate these findings in diverse ICU populations.
横纹肌溶解症在重症监护病房（ICU）中较为常见，但其临床特征和预后指标尚未得到全面界定。本研究旨在确定ICU中横纹肌溶解症患者的临床特征和结局，并评估横纹肌溶解症是否可预测结局。
这项回顾性研究调查了2022年至2023年入住上海宝山区吴淞中心医院ICU的患者。分析了临床和实验室指标以及出院结局。
该研究纳入了151例患者，分为对照组（CK≤1000 U/L，n = 117）和横纹肌溶解症组（CK>1000 U/L，n = 34）。横纹肌溶解症组男性比例更高（76.5%对56.4%，p = 0.035）、感染比例更高（88.2%对68.4%，p = 0.022）、肌肉无力比例更高（41.2%对13.7%，p = 0.035）以及肌红蛋白>1000 U/L的比例更高（55.9%对14.5%，p<0.001），但恶性肿瘤发生率更低（0%对17.9%，p = 0.017）。横纹肌溶解症组的不良结局率（POR，死亡和停止治疗的综合率）显著更高（52.9%对33.3%，p = 0.038）。多因素逻辑回归分析确定男性[比值比（OR），1.120 - 7.147；p = 0.028]、脓毒症[OR，1.234 - 10.949；p = 0.019]和机械通气[OR，1.489 - 8.478；p = 0.004]是ICU患者不良结局的独立危险因素。横纹肌溶解症不是独立危险因素。
ICU中患有横纹肌溶解症的患者不良结局发生率显著更高。男性、脓毒症和机械通气被确定为不良结局的独立危险因素，而横纹肌溶解症本身未被发现是独立危险因素。需要进行前瞻性研究以在不同的ICU人群中验证这些发现。
