Clinical outcomes of rhabdomyolysis & validation of McMahon Score for risk prediction

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dc.contributor.authorMathew, Manjuen_US
dc.contributor.authorPillai, Subhash Chandran Bhaskaranen_US
dc.date.accessioned2025-05-09T09:44:53Z
dc.date.available2025-05-09T09:44:53Z
dc.date.issued2024-01
dc.description.abstractBackground & objectives: Rhabdomyolysis in tropics has a unique aetiology and clinical profile. The objective of this study was to determine the aetiology and clinical outcomes of rhabdomyolysis and validate the McMahon risk prediction score in affected individuals from south India. Methods: A retrospective study of affected individuals with rhabdomyolysis admitted to a tertiary care hospital in south India, between January 2015 and June 2020, was undertaken. In-patients who were ?15 yr in age and had creatinine phosphokinase ?5000 U/l were included in the study. Cardiac, stroke, chronic muscular diseases and chronic kidney disease on maintenance haemodialysis were excluded. The incidence of acute kidney injury (AKI) in this group was calculated. Other clinical outcomes determined were 28-day mortality, proportion of individuals who required renal replacement therapy (RRT), intensive care unit (ICU) admission, vasopressors, mechanical ventilation (MV), number of days on mechanical ventilator and length of stay in ICU and hospital. Validation of McMahon risk prediction score for the requirement of RRT and mortality was performed. Results: Major aetiologies identified in the 75 study participants included were infections, trauma and seizures. Twenty eight-day mortality was 24 per cent (n=18). AKI incidence was 68 per cent, out of which 43.1 per cent had RRT. AKI in all survivors became dialysis independent. Vasopressors, MV and ICU requirement were 30.7, 32 and 77.3 per cent, respectively. Receiver operator characteristic curve for RRT and mortality risk prediction based on the McMahon Score showed a sensitivity of 71.4 per cent and specificity of 77.8 per cent for a cut-off ?7.8. Interpretation & conclusions: Rhabdomyolysis in tropics is associated with significant organ dysfunction and mortality. Although the incidence of AKI and RRT is high, the overall renal outcome is good among survivors. The wide confidence intervals for the area under curve for McMahon Score limit its predictability for RRT and mortality.en_US
dc.identifier.affiliationsDepartment of Critical Care, Pushpagiri Medical College Hospital, Thiruvalla, Kerala, Indiaen_US
dc.identifier.affiliationsDepartment of Nephrology, Pushpagiri Medical College Hospital, Thiruvalla, Kerala, Indiaen_US
dc.identifier.citationMathew Manju, Pillai Subhash Chandran Bhaskaran . Clinical outcomes of rhabdomyolysis & validation of McMahon Score for risk prediction. Indian Journal of Medical Research. 2024 Jan; 159(1): 102-108en_US
dc.identifier.issn0971-5916
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/244897
dc.languageenen_US
dc.publisherWolters Kluwer – Medknowen_US
dc.relation.issuenumber1en_US
dc.relation.volume159en_US
dc.source.urihttps://dx.doi.org/10.4103/ijmr.ijmr_2733_21en_US
dc.subjectAcute kidney injuryen_US
dc.subjectcreatinine kinaseen_US
dc.subjectcreatinine phosphokinaseen_US
dc.subjectMcMahon Scoreen_US
dc.subjectrhabdomyolysisen_US
dc.titleClinical outcomes of rhabdomyolysis & validation of McMahon Score for risk predictionen_US
dc.typeJournal Articleen_US
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