title: Association of rhabdomyolysis with renal outcomes and mortality in burn patients.
abstract: The contribution of rhabdomyolysis to acute kidney injury (AKI) in the context of burn injury is poorly studied. We sought to determine the impact of rhabdomyolysis on AKI (defined by the AKI Network classification), renal replacement therapy (RRT), and death. Patients admitted to the burn unit at our institution were examined. Information on sex, age, presence of inhalation injury, electrical burn, percentage TBSA burned, percentage of full-thickness burns, Injury Severity Score, and peak creatine kinase (CK) were recorded. These variables were examined via multivariate logistic regression analysis against AKI Network stage, RRT, and death. Of 1973 consecutive admissions meeting the inclusion criteria, 525 met our eligibility criteria. Log peak CK was found to be correlated with any stage of AKI (odds ratio [OR], 1.71; 95% confidence interval [CI], 1.36-2.16; P < .0001), moderate to severe AKI (OR, 2.09; 95% CI, 1.40-3.11; P = .0003), need for RRT (OR, 1.67; 95% CI, 1.16-2.40; P = .0057), and mortality (OR, 1.49; 95% CI, 1.01-2.20; P = .0441), after adjustment. Each 10-fold increase in peak CK was associated with a 70% increase in the odds of AKI, more than a 100% increase in the odds of moderate to severe AKI, a nearly 70% increase in the odds of RRT, and an almost 50% increase in the odds of mortality in patients with burn injury.
authors.affiliation: Department of Medicine, San Antonio Military Medical Center, Fort Sam Houston, Texas 78234, USA.
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Stewart
authors.forename: Casey L
authors.initials: CL
authors.lastname: Cotant
authors.forename: Molly A
authors.initials: MA
authors.lastname: Tilley
authors.forename: Todd F
authors.initials: TF
authors.lastname: Huzar
authors.forename: James K
authors.initials: JK
authors.lastname: Aden
authors.forename: Brian D
authors.initials: BD
authors.lastname: Snow
authors.forename: Christopher
authors.initials: C
authors.lastname: Gisler
authors.forename: Keith W
authors.initials: KW
authors.lastname: Kramer
authors.forename: Jesse R
authors.initials: JR
authors.lastname: Sherratt
authors.forename: Clinton K
authors.initials: CK
authors.lastname: Murray
authors.forename: Lorne H
authors.initials: LH
authors.lastname: Blackbourne
authors.forename: Evan M
authors.initials: EM
authors.lastname: Renz
authors.forename: Kevin K
authors.initials: KK
authors.lastname: Chung
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology*; D000328:Adult; D002056:Burns / Q000150:complications*; D016009:Chi-Square Distribution; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D012189:Retrospective Studies; D012206:Rhabdomyolysis / Q000150:complications*; D018709:Statistics, Nonparametric
chemical_list: D003402:Creatine Kinase