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a 10-year retrospective study of patients treated in a medical department

Vangstad, Mariea; Bjornaas, Mari A.a; Jacobsen, Daga,b

European Journal of Emergency Medicine: June 2019 - Volume 26 - Issue 3 - p 199–204
doi: 10.1097/MEJ.0000000000000510
Original articles

Background Rhabdomyolysis is a common and potentially life-threatening syndrome, and acute kidney injury (AKI) is a serious complication. We performed a 10-year retrospective study that included all patients treated for rhabdomyolysis in a medical clinic. We examined the relationships between the levels of creatine kinase (CK), myoglobin, and creatinine (as a marker of renal function and thereby AKI), and whether the myoglobin/CK ratio could be a valuable tool in the clinical evaluation of this patient group. Clinical characteristics were noted.

Patients and methods The study included all patients treated for rhabdomyolysis in the Department of Medicine, Oslo University Hospital Ulleval, from 2003 to 2012. Rhabdomyolysis was defined as a serum CK activity more than five times the upper reference limit.

Results A total of 341 patients were included in the study; 51% developed AKI, and 20% of those required dialysis. Logistic regression showed that myoglobin concentration [P < 0.001, odds ratio (OR) = 6.24] was a better predictor than CK activity (P = 0.001, OR = 3.45) of the development of AKI. The myoglobin/CK ratio was a good predictor of AKI (P < 0.001, OR = 5.97). The risk of developing AKI increased with increasing myoglobin/CK ratio (P < 0.001); a ratio more than 0.2 was associated with an increased likelihood of developing AKI.

Conclusion Serum myoglobin concentration was a better predictor of AKI than was serum CK activity. The myoglobin/CK ratio may be useful for assessing the likelihood of developing AKI.

aDepartment of Acute Medicine, Oslo University Hospital Ulleval

bInstitute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway

Received 11 April 2017 Accepted 22 September 2017

Correspondence to Marie Vangstad, MD, Department of Acute Medicine, Oslo University Hospital Ulleval, PO Box 4956 Nydalen, N-0424 Oslo, Norway, Tel: + 47 90 824 669; fax: + 47 23 015 400; e-mail:

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