Association of Rhabdomyolysis with Renal Outcomes and Mortality in Burn Patients
ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX
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The contribution of rhabdomyolysis to acute kidney injury AKI in the context of burn injury is poorly studied. We sought to determine the impact of rhabdomyolysis on AKI defined by the AKI Network classification, renal replacement therapy RRT, and death. Patients admitted to the burn unit at our institution were examined. Information on sex, age, presence of inhalation injury, electrical burn, percentage TBSA burned, percentage of full-thickness burns, Injury Severity Score, and peak creatine kinase CK were recorded. These variables were examined via multivariate logistic regression analysis against AKI Network stage, RRT, and death. Of 1973 consecutive admissions meeting the inclusion criteria, 525 met our eligibility criteria. Log peak CK was found to be correlated with any stage of AKI odds ratio OR, 1.71 95 confidence interval CI, 1.36-2.16 P .0001, moderate to severe AKI OR, 2.09 95 CI, 1.40-3.11 P .0003, need for RRT OR, 1.67 95 CI, 1.16-2.40 P .0057, and mortality OR, 1.49 95 CI, 1.01-2.20 P .0441, after adjustment. Each 10-fold increase in peak CK was associated with a 70 increase in the odds of AKI, more than a 100 increase in the odds of moderate to severe AKI, a nearly 70 increase in the odds of RRT, and an almost 50 increase in the odds of mortality in patients with burn injury.
- Medicine and Medical Research