title: Role of Elevated Aminotransferases in ICU Patients with Rhabdomyolysis.
abstract: To evaluate whether patients with rhabdomyolysis and serum alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) higher than 1000 IU/L had higher mortality that patients with low aminotransferases. Retrospective analysis of intensive care unit patients with rhabdomyolysis [creatine kinase (CK) higher than 5000 IU/L]. Patients were classified in two groups: low aminotransferases group, when AST and ALT were equal or lower to 1000 IU/L, and elevated aminotransferases group, when AST or ALT was above 1000 IU/L. Forty-six out of 189 patients included in the analysis (24.3%) had elevated aminotransferases. The mortality of patients with rhabdomyolysis was 25.9 per cent, being higher in patients with elevated aminotransferases compared with patients with low aminotransferases (60.9% vs 14.7%; P < 0.001). Mortality stratified by quartiles of CK in patients with low aminotransferases was independent of the level of CK (P = 0.67). Logistic regression analysis showed that the independent variables associated with mortality were Simplified Acute Physiology Score II [1.11 (1.07-1.16) for each point of increase, P < 0.001], the international normalized ratio value [4.2 (1.6-10.7) for each point of increase, P = 0.003], and the need of renal replacement therapy [5.4 (1.7-17.2), P = 0.004]. Patients with rhabdomyolysis with elevated serum aminotransferases had higher mortality than patients with low serum aminotransferase levels.
authors.affiliation: Servei de Medicina Intensiva, Hospital Universitari Son Espases, Palma de Mallorca, Illes Balears, Spain.
authors.forename: Joan M
authors.initials: JM
authors.lastname: Raurich
authors.forename: Juan A
authors.initials: JA
authors.lastname: Llompart-Pou
authors.forename: Miguel
authors.initials: M
authors.lastname: Rodríguez-Yago
authors.forename: Mireia
authors.initials: M
authors.lastname: Ferreruela
authors.forename: Cristina
authors.initials: C
authors.lastname: Royo
authors.forename: Ignacio
authors.initials: I
authors.lastname: Ayestarán
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012206:Rhabdomyolysis / Q000201:enzymology* / Q000401:mortality; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase