Elevation of serum creatine phosphokinase in hospitalized patients.
BACKGROUND
The clinical characteristics and outcomes of patients with significant noncardiac and cardiac serum creatine phosphokinase (CPK) elevations are not well described.


METHODS
One hundred fifty-eight inpatients who had CPK elevation of >1000 IU/L were identified. One hundred thirty-seven patients whose CPK elevations could be attributed to either noncardiac or cardiac etiologies were included and analyzed for clinical characteristics, 30-day, 3-month, and 1-year all-cause mortality rates. Twenty-one patients were excluded, in whom noncardiac and cardiac CPK (CCPK) elevations coexisted, or etiologies were unclear.


RESULTS
Of the 137 patients, 43 (31%) patients had CCPK elevation and 94 (69%) patients had noncardiac CPK (NCCPK) elevation. One-year mortality rate was 26.6% (25 of 94 patients) in NCCPK elevation group. Decedents were older (P < 0.05), had higher blood urea nitrogen (P < 0.01) and creatinine (P < 0.05) levels, and had higher white blood cell counts (P < 0.05) compared with survivors. In CCPK elevation group, 37.2% (16 of 43 patients) died within 1 year after admission. Decedents were also older (P < 0.01) and had higher blood urea nitrogen (P < 0.01) and creatinine (P < 0.01) levels.


CONCLUSIONS
The incidence of NCCPK elevation is greater than that of CCPK elevation in a veteran, mostly male, population. One-year mortality rate in patients with NCCPK elevation is comparable to that in patients with CCPK elevation (26.6% versus 37.2%, P = 0.290). Age and renal insufficiency are 2 major predictors for increased mortality in both groups.
Geriatrics and Palliative Care, University of Virginia Health, Charlottesville, Virginia, USA.
Khalil A
KA
Amir
Sydney X
SX
Chen
Ravi K
RK
Bobba
Edward L
EL
Arsura
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D015897:Comorbidity; D003402:Creatine Kinase / Q000097:blood*; D017052:Hospital Mortality / Q000639:trends; D006760:Hospitalization / Q000706:statistics & numerical data; D006787:Hospitals, Veterans; D006801:Humans; D007238:Infarction / Q000097:blood* / Q000401:mortality; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D051437:Renal Insufficiency / Q000097:blood* / Q000401:mortality; D012189:Retrospective Studies; D014728:Veterans
D015415:Biomarkers; D003402:Creatine Kinase