Rhabdomyolysis: an overview and study of outcomes in smoking and non-smoking patients at WVU hospitals
Hancox, J.G.; Welch, J.; Schmidt, R.; Ogershok, P.
West Virginia Medical Journal 99(4): 148-151
2003
ISSN/ISBN: 0043-3284 PMID: 14650900 Document Number: 558336
The purpose of this study was to review the etiology, diagnosis, treatment, and outcomes of cases of rhabdomyolysis at West Virginia University Hospitals. Another goal was to determine if smokers had worse outcomes than non-smokers. Rhabdomyolysis was defined as a fivefold or greater elevation above the upper limit of normal in creatine kinase (CK) levels with a muscle/brain (MB) fraction of < 5% in patients with a known risk factor for this disorder. During the 12 years from 1989 to 2001, 69 patients met our study criteria. The most common causes were infection and trauma. Of the 69 patients, 32% developed acute renal failure (ARF) which is defined as an elevation in creatinine to 2.0 mg/dL or greater. Although all patients received intravenous fluids (IVF), many did not receive other treatments such as sodium bicarbonate, furosemide, and mannitol. There was no significant difference in peak serum creatinine or creatine kinase (CK) levels between smokers and non-smokers. Eleven of the 13 patients required dialysis (p = 0.031), 17 of the 22 had ARF (p = 0.026), and all nine patients who died were smokers (p = 0.008). Thus, smokers with rhabdomyolysis have higher morbidity and mortality rates than non-smokers.