Predicting Factors for Acute Renal Failure Induced by Rhabdomyolysis at the Early Stage of Multiple Trauma.
- Author:
Joong Bum MOON
1
;
Kang Hyun LEE
;
Sung Oh HWANG
;
Jin Woong LEE
;
Byoung Guen HAN
;
Seung Ok CHOI
;
Sung Joon KANG
Author Information
1. Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea.
- Publication Type:Original Article
- Keywords:
Rhabdomyolysis;
Acute renal failure;
Multiple trauma
- MeSH:
Acute Kidney Injury*;
Arterial Pressure;
Blood Gas Analysis;
Communicable Diseases;
Creatine;
Creatine Kinase;
Emergency Service, Hospital;
Heart Rate;
Humans;
Injury Severity Score;
Logistic Models;
Mortality;
Multiple Trauma*;
Myocardial Infarction;
Myoglobin;
Observational Study;
Oxidoreductases;
Plasma;
Prospective Studies;
Rhabdomyolysis*;
Stroke;
Trauma Centers
- From:Journal of the Korean Society of Emergency Medicine
2001;12(3):222-229
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Acute renal failure(ARF) is a serious complication of rhabdomyolysis after multiple trauma, and may increase morbidity and mortality. The aim of this study was to elucidate predicting factors for the development of ARF induced by rhabdomyolysis at an early stage of multiple trauma. METHODS: This prospective, observational study was conducted at the emergency department of a level I trauma center. Patients with acute multiple trauma, whose plasma levels of creatine phosphokinase(CPK) were higher than 1,000 IU, were included in this study. We excluded patients with any history of myocardial infarction, stroke, underlying renal disease, and/or infectious disease. We collected clinical and laboratory data including age, heart rate, mean arterial blood pressure, injury severity score, serum myoglobin, lactic dehydrogenase, creatine phosphokinase, and base excess. Collected data were compared between patients who had ARF and patients who did not have ARF. RESULTS: Eighty-eight patients were enrolled in this study. Eighteen patients(20.5%) developed ARF. The injury severity score(ISS)(p=0.001), the base excess(p<0.001), CPK(p=0.003), and myoglobin(p<0.001) were higher in patients with ARF than in patient without ARF. Logistic regression analysis revealed that early predictors for ARF were high ISS, high base excess, high CPK, and high myoglobin. CONCLUSION: We could identify early predicting factors for acute renal failure induced by rhabdomyolysis, these factors included ISS, serum CPK and myoglobin, and base excess in the arterial blood gas analysis performed at the emergency department.
