Journal of Trauma and Injury

Jung Yun Park

2 Articles

Early Predictive Values for Severe Rhabdomyolysis in Blunt Trauma: Jung Yun Park, Myoung Jun Kim, Jae Gil Lee; J Trauma Inj. 2019;32(1):26-31. Published online March 31, 2019; DOI: https://doi.org/10.20408/jti.2018.029

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Purpose

Rhabdomyolysis (RB) is a syndrome characterized by the decomposition of striated muscles and leakage of their contents into the bloodstream. Acute kidney injury (AKI) is the most significant and serious complication of RB and is a major cause of mortality in patients with RB. Severe RB (creatine kinase [CK] ≥5,000) has been associated with AKI. However, early prediction is difficult because CK can reach peak levels 1?3 days after the trauma. Hence, the aim of our study was to identify predictors of severe RB using initial patient information and parameters.

Methods

We retrospectively analyzed 1,023 blunt trauma patients admitted to a single tertiary hospital between August 2011 and March 2018. Patients with previously diagnosed chronic kidney disease were excluded from the study. RB and severe RB were defined as a CK level ≥1,000 U/L and ≥5,000 U/L, respectively. The diagnosis of AKI was based on RIFLE criteria.

Results

The overall incidence of RB and severe RB was 31.3% (n=320) and 6.2% (n=63), respectively. On multivariable analysis, male sex (odds ratio [OR] 3.78, 95% confidence interval [CI] 1.43 to 10.00), initial base excess (OR 0.85, 95% CI 0.80 to 0.90), initial CK (OR 2.07, 95% CI 1.67 to 2.57), and extremity abbreviated injury scale score (OR 1.78, 95% CI 1.39 to 2.29) were found to predict severe RB. The results of receiver operating characteristic analysis showed that the best cutoff value for the initial serum CK level predictive of severe RB was 1,494 U/L.

Conclusions

Male patients with severe extremity injuries, low base excess, and initial CK level >1,500 U/L should receive vigorous fluid resuscitation.

Summary

Citations

Citations to this article as recorded by

Factors Associated with Acute Kidney Injury Occurrence and Prognosis in Rhabdomyolysis at the Emergency Department
Jun Seok Seo, Inhwan Yeo, Changho Kim, Daeun Kim, Jeong-Hoon Lim, Kyoungtae Park, Jiwoo Jeong, Hojin Kwon, Yuna Cho, Sungyeon Park
Medicina.2024; 60(1): 105. CrossRef
Case Report: Urinary Proteomic Analysis of Exercise-Induced Rhabdomyolysis with Acute Kidney Injury
Andréia Carneiro da Silva, Janaina Macedo da Silva, Verônica Feijoli Santiago, Priscila Robertina dos Santos Donado, Gilberto Santos de Oliveira, Zeinab Ghasemishahrestani, Josino Costa Moreira, Cíntia Verdan Lucena, Diego Viana Gomes, Gianna Mastroianni
Qeios.2024;[Epub] CrossRef
Role of the Neutrophil-to-Lymphocyte Ratio at the Time of Arrival at the Emergency Room as a Predictor of Rhabdomyolysis in Severe Trauma Patients
Jin Chul Bae, Kyung Hoon Sun, Yong Jin Park
Journal of Trauma and Injury.2020; 33(2): 96. CrossRef

Usefulness of Shock Index to Predict Outcomes of Trauma Patient: A Retrospective Cohort Study: Myoung Jun Kim, Jung Yun Park, Mi Kyoung Kim, Jae Gil Lee; J Trauma Inj. 2019;32(1):17-25. Published online March 31, 2019; DOI: https://doi.org/10.20408/jti.2018.034

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233 Download
13 Citations

Abstract PDF

Purpose

We investigated how prehospital, emergency room (ER), and delta shock indices (SI) correlate with outcomes including mortality in patients with polytrauma.

Methods

We retrospectively reviewed the medical records of 1,275 patients who visited the emergency department from January 2015 to April 2018. A total of 628 patients were enrolled in the study. Patients were divided into survivor and non-survivor groups, and logistic regression analysis was used to investigate independent risk factors for death. Pearson coefficient analysis and chi-square test were used to examine the significant relationship between SI and clinical progression markers.

Results

Of 628 enrolled patients, 608 survived and 27 died. Multivariate logistic regression analysis reveals “age” (p<0.001; OR, 1.068), “pre-hospital SI >0.9” (p<0.001; OR, 11.629), and “delta SI ≥0.3” (p<0.001; OR, 12.869) as independent risk factors for mortality. Prehospital and ER SIs showed a significant correlation with hospital and intensive care unit length of stay and transfusion amount. Higher prehospital and ER SIs (>0.9) were associated with poor clinical progression.

Conclusions

SI and delta SI are significant predictors of mortality in patients with polytrauma. Moreover, both prehospital and ER SIs can be used as predictive markers of clinical progression in these patients.

Summary

Citations

Citations to this article as recorded by

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Trauma.2025;[Epub] CrossRef
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Areej Zehra, Inayat Ali Khan, Muhammad Khan, Shahid Pervez Shaikh, Padma Rathore, Ghazal Irfan
Pakistan Journal of Health Sciences.2025; : 209. CrossRef
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Rasha Mahmoud Ahmed, Bassant Sayed Moussa, Mohamed Amin Ali, Aml Ibrahiem Sayed Ahmed Abo El Sood, Gouda Mohamed El Labban
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World Journal of Critical Care Medicine.2024;[Epub] CrossRef
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Journal of Surgical Research.2023; 291: 204. CrossRef
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Malene Vang, Maria Østberg, Jacob Steinmetz, Lars S. Rasmussen
European Journal of Trauma and Emergency Surgery.2022; 48(4): 2559. CrossRef
Outcomes of Trauma Patients Present to the Emergency Department with a Shock Index of ≥1.0
Sharfuddin Chowdhury, P. J. Parameaswari, Luke Leenen
Journal of Emergencies, Trauma, and Shock.2022; 15(1): 17. CrossRef
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