Risk Factors and Preventive Strategies of Exertional Rhabdomyolysis Patients with Emergency Admission

• Main Authors: Aming Chor-Ming Lin, 連楚明
• Other Authors: 蔡行瀚
• Format: Others
• Language: zh-TW
• Published: 2010
• Online Access: http://ndltd.ncl.edu.tw/handle/76431480979204519249

碩士 === 臺北醫學大學 === 傷害防治學研究所 === 98 === Objective: To examine the association between exertional rhabdomyolysis and risk factors for hospitalization of exertional rhabdomyolysis. Methods: A retrospective study was conducted in adolescents diagnosed with exertional rhabdomyolysis in the emergency department of a medical center hospital for an episode of endurance test in a high school in Taipei city, Taiwan. Total 225 adolescents had been told to perform repetitive squat-jumps of physical fitness. We enrolled 119 patients who had presented to the emergency department after onset of generalized muscle aches and dark urine. The clinical presentation, sex, risk factors, distribution of serum creatine kinase and glutamic oxaloacetic transaminase levels were compared. We evaluated the incidence and risk factors of hospitalization for exertional rhabdomyolysis. Results: Of the 119 patients visited to the emergency department with a diagnosis of exertional rhabdomyolysis. There were 78 male and 41 female patients (age range 17-18 years, mean 17.6). Serum creatine kinase activity was 55-174260 U/L (mean 36512 U/L) (normal range 50-450). The mean GOT levels in patients was 250±456 U/L (normal range 10-35). Ninety nine adolescents were discharged after tolerance with oral hydration. Twenty required hospital admission. Poor appetite, general malaise, muscle pain, tea urine and systemic inflammatory response syndrome were the most common symptoms and signs. The risk factors for hospitalization of exertional rhabdomyolysis were statistically significant differences in proper traning (OR, 7.03; 95% CI, 1.62-30.56), fasting (OR, 5.3; 95% CI, 1.42-19.67), without oral hydration (OR, 5.90; 95% CI 1.67-20.84) and systemic inflammatory response syndrome (OR, 10.6; 95% CI 2.3-26.6). Conclusions: The findings suggest that adolescents with fasting before exercise , no traing before exercise, no oral hydration after exercise and systemic inflammatory response syndrome are at increased risk of admission. We can propose the guideline for admission and serve as a resource for developing and implementing prevention plans of exertional rhabdomyolysis.