Rhabdomyolysis in intensive care unit-distinctive clinical indicators and prognosis.

Abstract

Background: Rhabdomyolysis is commonly encountered in intensive care unit (ICU), yet its clinical features and prognostic indicators have not been comprehensively defined. This study aims to identify clinical characteristics and outcomes of ICU patients with rhabdomyolysis, and assess if rhabdomyolysis predicts outcomes.

Methods: This retrospective study investigated patients admitted to the ICU of Shanghai Baoshan District Wusong Central Hospital from 2022 to 2023. Clinical and laboratory indices, along with discharge outcomes, were analyzed.

Results: The study included 151 patients, divided into Control group (CK ≤ 1000 U/L, n = 117) and RML group (CK > 1000 U/L, n = 34) groups. The RML group showed higher proportions of male gender (76.5% vs. 56.4%, p = 0.035), infection (88.2% vs. 68.4%, p = 0.022), muscle weakness (41.2% vs. 13.7%, p = 0.035), and myoglobin > 1000 U/L (55.9% vs. 14.5%, p < 0.001), but lower incidence of malignant tumors (0% vs. 17.9%, p = 0.017). The poor outcome rate (POR, the combined rate of death and cessation of treatment) was significantly higher in the RML group (52.9% vs. 33.3%, p = 0.038). Multivariate logistic regression analysis identified male gender [OR, 1.120-7.147; p = 0.028], sepsis [OR, 1.234-10.949; p = 0.019], and mechanical ventilation [OR, 1.489-8.478; p = 0.004] as independent risk factors for poor outcome in ICU patients. Rhabdomyolysis was not an independent risk factor.

Conclusions: ICU patients with rhabdomyolysis experienced a significantly higher rate of poor outcomes. Male gender, sepsis, and mechanical ventilation were identified as independent risk factors for poor outcomes, while rhabdomyolysis itself was not found to be an independent risk factor. Prospective research is needed to validate these findings in diverse ICU populations.