Researchers from Brigham and Women's Hospital (BWH) have developed a risk score calculation that can help predict which patients with rhabdomyolysis (a condition that occurs due to muscle damage) may be at risk for the severe complication of kidney failure or death. This research will publish online September 2, 2013 in JAMA Internal Medicine.
Rhabdomyolysis occurs when muscles are crushed and rupture, leaking toxic compounds into the circulation and can be caused by any condition that damages skeletal muscle and causes injury. Risk factors include crush injuries, alcoholism, heat stroke or severe exertion including strenuous exercise and as a rare side effect of taking cholesterol lowering medications called statins. One of the compounds called myoglobin can get caught in the kidneys and cause kidney failure and even death in severe cases.
"Currently doctors cannot easily predict which patients are most likely to have severe kidney failure or die from rhabdomyolysis," explained Gearoid McMahon, MB, BCh, a clinical fellow in BWH's Department of Medicine and lead author on this study. "Using routinely available clinical variables, we have developed a new risk prediction score that doctors can use to help predict a patient's expected outcome and plan for treatment accordingly."
The researchers conducted a retrospective cohort study of 2,371 patients admitted between 2000 and 2011 and analyzed variables that are thought to be associated with poor outcomes in this patient population, such as age, gender, and CPK levels. Using data from this analysis, researchers created a risk prediction score based on the variables that were most significantly associated with poor outcomes. The final variables that were included in the created model were age, gender, levels of initial phosphate, calcium, creatinine and CO2, CPK, and cause of rhabdomyolysis.