Predicting Factors for Acute Renal Failure Induced by Rhabdomyolysis at the Early Stage of Multiple Trauma

Moon,  Joong Bum; Lee,  Kang Hyun; Hwang,  Sung Oh; Lee,  Jin Woong; Han,  Byoung Guen; Choi,  Seung Ok; Kang,  Sung Joon

J Korean Soc Emerg Med > Volume 12(3); 2001 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2001;12(3): 222-229.

Predicting Factors for Acute Renal Failure Induced by Rhabdomyolysis at the Early Stage of Multiple Trauma

Joong Bum Moon, Kang Hyun Lee, Sung Oh Hwang, Jin Woong Lee, Byoung Guen Han, Seung Ok Choi, Sung Joon Kang

¹Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea.
²Department of General Surgery, Wonju College of Medicine, Yonsei University, Wonju, Korea.
³Department of Nephrology, Wonju College of Medicine, Yonsei University, Wonju, Korea.

ABSTRACT

BACKGROUND: Acute renal failure(ARF) is a serious complication of rhabdomyolysis after multiple trauma, and may increase morbidity and mortality. The aim of this study was to elucidate predicting factors for the development of ARF induced by rhabdomyolysis at an early stage of multiple trauma.
METHODS:
This prospective, observational study was conducted at the emergency department of a level I trauma center. Patients with acute multiple trauma, whose plasma levels of creatine phosphokinase(CPK) were higher than 1,000 IU, were included in this study. We excluded patients with any history of myocardial infarction, stroke, underlying renal disease, and/or infectious disease. We collected clinical and laboratory data including age, heart rate, mean arterial blood pressure, injury severity score, serum myoglobin, lactic dehydrogenase, creatine phosphokinase, and base excess. Collected data were compared between patients who had ARF and patients who did not have ARF.
RESULTS:
Eighty-eight patients were enrolled in this study. Eighteen patients(20.5%) developed ARF. The injury severity score(ISS)(p=0.001), the base excess(p<0.001), CPK(p=0.003), and myoglobin(p<0.001) were higher in patients with ARF than in patient without ARF. Logistic regression analysis revealed that early predictors for ARF were high ISS, high base excess, high CPK, and high myoglobin.
CONCLUSION:
We could identify early predicting factors for acute renal failure induced by rhabdomyolysis, these factors included ISS, serum CPK and myoglobin, and base excess in the arterial blood gas analysis performed at the emergency department.

Key words: Rhabdomyolysis, Acute renal failure, Multiple trauma