Evaluation of Clinical Outcomes in Hospitalized Patients With Exertional Rhabdomyolysis.

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Evaluation of Clinical Outcomes in Hospitalized Patients With Exertional Rhabdomyolysis.

J Am Osteopath Assoc. 2019 Jul 01;119(7):428-434

Authors: Arnautovic JZ, Tereziu S

Context: Exertional rhabdomyolysis (ER) is a medical condition in which excessive and unaccustomed physical activity results in skeletal muscle damage in otherwise healthy individuals.
Objective: To assess the overall outcomes of patients who presented to the emergency department with ER.
Methods: This retrospective study was conducted across 4 hospitals. The study included nonpregnant adults with no history of renal function impairment or myopathy disorder who had a diagnosis of ER in the emergency department setting. Medical records were reviewed for patient demographics, length of stay, complications, mechanism(s) of injury involved, impact of nutritional supplements, spectrum of creatine kinase (CK) responses, prevalence of hospital readmissions, and overall mortality.
Results: Of the 800 rhabdomyolysis cases identified during the 24-month study period, 41 were included in the study. The mean age was 29 years, and the patients were predominantly male (33 [80.5%]) and white (25 [61%]). The median length of stay was 2 days, and it correlated significantly with initial and peak CK levels (R=0.45, P=.004, and R=0.52, P<.001, respectively). Median initial and peak CK were noted to be 16,888 (range, 342-194,403) U/L and 18,534 (range, 342-287,565) U/L, respectively. Median discharge CK was 5287 (range, 10-61,617) U/L. The most commonly cited mechanism of injury was weight lifting (16 [39%]). In terms of overall outcomes, transient kidney injury was noted in 3 cases (7.4%), and no mortality was recorded during the admission or at 12 months of follow-up. Compartment syndrome or severe electrolyte abnormalities were not observed. There were only 2 uncomplicated readmissions (4.8%) due to high-intensity interval training.
Conclusion: Hospitalized patients with ER without a history of renal impairment tend to have relatively low risks of complications and readmission.

PMID: 31233108 [PubMed - in process]

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