Relationship Between Rhabdomyolysis And Prognosis In Septic Patients

Objective : To explore the relationship between rhabdomyolysis(RM)and severity as well as prognosis in septic patients.Methods: A total of 151 patients with sepsis continuously admitted to the Intensive Care Unit(ICU)between October 2014 and September 2015 were included in this prospective study.Venous blood samples of patients were drawn to detect serum concentration of creatine kinase(CK).According to the diagnosis criteria of RM(CK≥1000 U/L),patients were divided into: RM group(n= 37)and non-RM group(n= 114).Infection markers,critical illness score,the incidence rate of organ dysfunction during ICU and 28-day mortality were compared between the two group.Results: Overall rate of RM was 24.5%in septic patients.Compared with non-RM group,serum levels of procalcitonin(PCT),APACHEⅡ score and SOFA score were higher in RM group(P<0.05).In patients with RM,the incidence rate of hepatic dysfunction,hemodynamic dysfunction,renal dysfunction,organ dysfunction per person,peak value of serum creatinine,the rate of continuous renal replacement therapy(RRT)and 28-day mortality were higher than those in patients without RM(P<0.05),while the incidence rate of respiratory dysfunction,hematologic dysfunction,and neurologic dysfunction during ICU showed no significant difference in two groups(P>0.05).The incidence rate of RM and the CK level in death group were both significantly higher than the survival group(P<0.01).CK had statistical significance in predicting 28-day mortality,area under ROC curve was 0.694(P<0.05),which was lower than APACHEⅡ score(0.841)and SOFA score(0.805)(P<0.05).Conclusion: The incidence rate of RM in septic patients was high.Septic patients with RM were more severe,the incidence of RM is associated with hepatic dysfunction,hemodynamic dysfunction,renal dysfunction during ICU and 28-day mortality in septic patients.CK may be used as reference index for predicting 28-day mortality of septic patients.