The Risk Factors On The Prognosis Of Patients With Rhabdomyolysis Syndrome

Objective Rhabdomyolysis is one kind of diseases induced by many causes.It may lead to fatal complications.Clinical symptoms of rhabdomyolysis are not typical,and patients' conditions in ICU are serious and complicated,and there are communication disorders in some patients,and the patients can not be timely diagnosed and can not receive regular treatment,all of these factors lead to a higher mortality and a worse prognosis in patients.This study is a retrospective analysis on the risk factors of the prognosis to the patients with rhabdomyolysis syndrome(RM).Methods 57 patients were diagnosed with RM in ICU of Anhui Provincial Hospital from January 2012 to April 2017.They were included in the study.The inclusion criteria were as follows:(1)There were causes of rhabdomyolysis,such as severe infection,trauma,poisoning and heat stroke.(2)CK levels was five times higher than the normal levels.(3)Myoglobin levels increased significantly in blood and urine,and the occult blood was positive in urine.Exclusion criteria:(1)The diseases can lead to high CK,such as the acute myocardial infarction and the acute liver failure.(2)Pregnant women.The patients were divided into the death group and the survival group.The data were compared between the two groups.The risk factors of prognosis were analyzed by logistic regression analysis.Results Compared with the survival group,the score of APACHE ?(P<0.01),blood uric acid,blood sugar,prothrombin time(PT),activation of partial thrombin time(APTT),myoglobin(MYO),creatine kinase isozyme(CK-MB),heart rate were higher significantly(P<0.05).The GCS score,blood haemoglobin(Hb),platelet count(Plt),total protein,albumin(Alb)and calcium were lower significantly(P<0.05)in the deathgroup.Additionally,compared to the survival group,they were more than that in the death group,such as the incidence of MODS,RM induced by infection,acute kidney injury,longer time of mechanical ventilation(P<0.05).But the rate of fast infusion was lower(P<0.05).It was revealed that APACHE II and GCS score,blood glucose,PT,APTT,MYO,CK-MB,Hb,Plt,Alb,calcium,fluid speed,mechanical ventilation time,early treatment,rapid liquid resuscitation were independent risk factors of prognosis by Logistic regression analysis.Conclusions Patients with RM on admission may generally suffers from severe coma and MODS,as well as severe internal environment disturbance and so on.This may lead to a higher mortality in patients.Patients with AKI may have a poor prognosis.Early diagnosis and treatment can conduce to control diseases,and prevent complications,and improve prognosis.Additionally,early rapid fluid replacement can reduce mortality in the patients with RM.