OBJECTIVE: To test the hypothesis that age influences rhabdomyolysis prognostic factors.
METHODS: This retrospective single-center observational study included all patients with a creatine kinase (CK) level greater than five times normal, admitted to Rennes University Hospital between 2013 and 2019. The primary endpoint was 30-day in-hospital mortality rate.
RESULTS: 343 patients were included (median age: 75 years). The mean peak CK was 21,825 IU/L. Acute renal failure occurred in 57.7% of the cases. For patients aged 70 years and over, the main etiology was prolonged immobilization after a fall. The 30-day in-hospital mortality rate was 10.5% (23 deaths). The Charlson score, number of medications and CK and creatinine levels varied according to age. Multivariate analysis showed age to be a factor that was associated, although not proportionally, with 30-day in-hospital mortality.
CONCLUSIONS: Factors influencing rhabdomyolysis severity were not randomly distributed according to age. The term rhabdomyolysis encompasses various clinical realities and is associated with different mechanisms. More research is needed to better understand the physio-pathological and prognostic factors of rhabdomyolysis, especially in older adults.
目的:验证年龄影响横纹肌溶解预后因素的假设。
方法:这项回顾性单中心观察性研究包括所有肌酸激酶(CK)水平高于正常值五倍的患者,2013年至2019年期间入住雷恩大学医院。主要终点是30天住院死亡率。
结果:343例患者(中位年龄:75岁)。平均峰值CK为21,825IU/L。57.7%的病例发生急性肾功能衰竭。对于70岁及以上的患者,主要病因是跌倒后长时间固定。30天住院死亡率为10.5%(23例死亡)。Charlson得分,用药数量和CK和肌酐水平因年龄而异.多变量分析显示年龄是相关因素,虽然不成比例,30天住院死亡率。
结论:影响横纹肌溶解严重程度的因素不按年龄随机分布。术语横纹肌溶解包括各种临床现实并且与不同的机制相关。需要更多的研究来更好地了解横纹肌溶解的生理病理和预后因素,尤其是老年人。