title: Analysis of factors influencing limb amputation in high-voltage electrically injured patients.
abstract: BACKGROUND
  Limb amputation is considered one of the most devastating consequences of electrical injury. Any factors that correlate with the degree of muscle damage can be used to predict the necessity of limb amputation. The aim of this study was to determine the factors that can be used to predict limb amputation in high-voltage electrically injured patients.
  
  
  METHODS
  Eighty-two high-voltage electrically injured patients were admitted to our hospital during a 17-year period. A retrospective analysis of the possible related risk factors between amputation and non-amputation patients was performed.
  
  
  RESULTS
  A total of 68 patients were enrolled for analysis. Thirteen patients underwent limb amputations. Multivariate analysis of the risk factors between amputation and non-amputation groups showed statistical significance for day 1 creatine kinase-isoenzyme MB (CK-MB) level. A serum CK-MB level above 80 ng/ml predicted high risk of limb amputation with high specificity (84%) and sensitivity (77%). Only one patient with a remarkable decrease of creatine kinase (CK) and CK-MB levels after fasciotomy avoided a major limb amputation.
  
  
  CONCLUSIONS
  Our results suggest that CK-MB level is an independent factor for prediction of limb amputation. We suggest that the addition of CK-MB evaluation to clinical symptoms screening may be a valuable method to early detection of muscle damage.
authors.affiliation: Department of Surgery, Section of Plastic and Reconstructive Surgery, Institute of Clinical Medicine, National Cheng Kung University Medical College and Hospital, Tainan 70428, Taiwan, ROC.
authors.forename: Yuan-Yu
authors.initials: YY
authors.lastname: Hsueh
authors.forename: Chung-Lin
authors.initials: CL
authors.lastname: Chen
authors.forename: Shin-Chen
authors.initials: SC
authors.lastname: Pan
mesh_terms: D000293:Adolescent; D000328:Adult; D000671:Amputation, Surgical; D015415:Biomarkers / Q000097:blood; D002058:Burns, Electric / Q000097:blood / Q000601:surgery*; D002648:Child; D052279:Creatine Kinase, MB Form / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D015415:Biomarkers; D052279:Creatine Kinase, MB Form