title: Creatine kinase as a prognostic indicator in electrical injury.
abstract: Serial serum creatine kinase (CK) and creatine kinase myocardial band isoenzyme (CK-MB) levels were obtained from 116 of 125 electrical burn patients admitted from 1976 through 1986. We divided patients into three groups (peak CK within 2 days after admission) as follows: group 1, CK less than 400 U/L; group 2, CK = 400 to 2500 U/L; group 3, CK greater than 2500 U/L. Clinical myocardial infarction (MI) was determined by ischemic ECG changes, LDH isoenzyme patterns, and clinical course. Skin grafts occurred in 2 of 24 patients from group 1, in 15 of 31 from group 2, and in 37 of 61 from group 3. Hospital stay (mean +/- SEM) was 4.6 +/- 1.3 days for group 1, 20.2 +/- 5.4 for group 2, and 37.7 +/- 3.6 for group 3. Group 1 patients required no amputations; group 2 had 1 limb and 5 digit amputations; group 3 had 22 limb and 16 digit amputations. Only three clinical MIs were found (all in group 3), although 1 of 31 patients from group 2 and 32 of 61 from group 3 had CK-MB greater than 4%. Highly elevated CK and CK-MB are associated with longer hospitalization, and a greater risk of skin grafting or amputation, than with levels less than 400 U/L. Clinical MI is rare and cannot be diagnosed by elevated CK-MB alone.
mesh_terms: D000293:Adolescent; D000328:Adult; D000671:Amputation, Surgical; D002058:Burns, Electric / Q000150:complications / Q000201:enzymology* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003402:Creatine Kinase / Q000097:blood*; D006801:Humans; D007223:Infant; D007527:Isoenzymes; D008875:Middle Aged; D009203:Myocardial Infarction / Q000201:enzymology / Q000209:etiology; D009206:Myocardium / Q000201:enzymology; D011379:Prognosis; D012307:Risk Factors; D016038:Skin Transplantation
chemical_list: D007527:Isoenzymes; D003402:Creatine Kinase