Introduction: Rhabdomyolysis is a condition where muscle damage leads to the leakage of intracellular contents such as myoglobin and creatine kinase. These leak into systemic circulation and can cause detrimental effects. Due to the detrimental effect of rhabdomyolysis on patient mortality and potential complications, identifying factors that affect patient mortality in those with rhabdomyolysis could provide valuable insight in early management strategies and potentially benefit patient outcomes.
Objective: The goal of this study was to identify independent predictors of in-hospital mortality in non-elderly adult patients who underwent emergency admission due to rhabdomyolysis.
Materials and methods: A retrospective cohort study was done by analyzing 27,688 non-elderly adult patients (18-64 years) with rhabdomyolysis who underwent emergency admission using the National Inpatient Sample (NIS) during 2005-2014. Factors such as demographic information, clinical course, and comorbidities were collected to identify predictors of in-hospital mortality. Chi square and student's t-tests were utilized to evaluate various group differences on categorical and continuous variables. Backward logistic regression analyses were performed to examine factors that could affect patient mortality.
Results: A total number of 27,688 non-elderly adult patients (age 18-64 years) were included, of which, 20,137 patients were male (72.8%) with a mean (SD) age of 40.60 (13.34) years, and 7,551 patients were female (27.3%) with a mean (SD) age of 45.63 (13.20) years. Multivariable backward logistic regression analysis was performed to evaluate the associations between mortality and different variables in our patient sample. Out of different factors, respiratory diseases, cardiac disease, and genitourinary system disease demonstrated the most significant association with mortality, shown by odds ratios of 3.67, 3.59, and 3.08, respectively. Additionally, patient age, history of surgical procedure, bacterial infection (other than tuberculosis), and cerebrovascular diseases were also positively associated with mortality. Their respective odds ratios were 1.03, 2.14, 2.13, and 2.66.
Conclusion: Each additional year in age leads to 3% increased odds of mortality in non-elderly adult patients who are emergently admitted with rhabdomyolysis.