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Table 1 Studies with epidemiological data

From: Beyond muscle destruction: a systematic review of rhabdomyolysis for clinical practice

Article Type of study Type of patients RM definition Etiologies Risk factors Patients with RM Comments
Mannix et al. 2006 [16] RS Pediatric patients in the ED CK level >1000 IU/L Viral myositis, trauma, connective tissue disease NA RM = 191 Most common reported symptoms were muscle pain and fever.
AKI developed in only nine patients
Lagandre et al. 2006 [17] POS 49 bariatric post-operative patients CK level >1000 IU/L NA Surgical time >4 h, diabetes, BMI >40 kg/m2 RM = 13 Type of surgeries performed were gastric banding or bypass
De Oliveira et al. 2009 [18] POS 22 bariatric post-operative patients An increase >5× the upper limit of the normal CK level NA Prolonged surgical duration RM = 17 Clinical neuromuscular symptoms occurred in 45 % of patients
Linares et al. 2009 [19] RS Hospitalized patients CK levels >5000 IU/L Recreational drugs and alcohol, trauma, compression, shock and statin use NA RM = 106 The authors suggest that RM should be defined using CK levels above 10–25 times the upper limit of normal. AKI developed in 52 patients
Youssef et al. 2010 [20] POS 23 bariatric post-operative patients Post-operative CK levels >1000 IU/L NA BMI >56 kg/m2 RM = 7 Factors such as sex, age, and length of surgery were not good predictors of RM
Alpers et al. 2010 [21] RS Patients in military training Muscle pain, weakness, or swelling over <7 days with a CK >5× the upper limit of normal Exertional RM NA RM = 177 Authors comment that exertional RM is associated with lower incidence of AKI
Bache et al. 2011 [22] RS 76 burn patients in the ICU “Late-onset” RM: CK >1000 U/L, 1 week or more after burn episode NA Sepsis, nephrotoxic drugs, hypokalemia “Late-onset” RM = 7 Authors suggest measuring CK in all patients with the risk factors described in burn patients to initiate prompt treatment
Oshima 2011 [23] RS Cases of drug-related RM NA Drug use <10 year olds, weight less than 50 kg RM = 8610 Lipid lowering drugs were most frequently reported as the associated drugs
Herraez Garcia et al. 2012 [24] RS Adult hospitalized patients CK level of 5× upper limit (975 UI/L) Trauma, sepsis, immobility Elder patients and male sex RM = 449 No relationship was found between CK levels and AKI development or mortality
El-Abdellati et al. 2013 [25] RS 1769 ICU patients CK level >1000 U/L Prolonged surgery, trauma, ischemia, infections Surgical duration >6 h, resuscitation, compartment syndrome RM = 342 The authors found a correlation between CK levels and the development of AKI
Rodriguez et al. 2013 [26] RS Acute-care hospital patients Severe RM: >5000 IU/L Immobilization, illicit drug abuse, infections, trauma NA Severe RM = 126 More than half of the patients developed AKI. Variables associated with poor outcome were hypoalbuminemia, metabolic acidosis, and decreased prothrombin time
Chen et al. 2013 [27] RS Pediatric patients in the ED CK levels >1000 IU/ Infection, trauma, exercise NA RM = 37 Common symptoms were muscle pain and weakness. Dark urine reported in 5.4 % of patients
Talving et al. 2013 [28] RS Pediatric trauma patients NA Trauma NA RM = 521 AKI occurred in 70 patients. The authors concluded that a CK level ≥3000 was an independent risk factor for developing AKI
Grunau et al. 2014 [29] RS Patients in the ED CK levels >1000 U/L Illicit drug use, infections, trauma NA RM = 400 AKI developed in 151 patients; 18 patients required hemodialysis
van Staa et al. 2014 [30] RS 641,703 statin users CK levels 10× the upper limit of normal Statin drug use Drug–drug interaction Reported with RM = 59
CK >10× = 182
The incidence of RM in this cohort of statin users was very low
Pariser et al. 2015 [31] RS 1,016,074 patients with a major urologic surgery NA NA Diabetes, chronic kidney disease, obesity, bleeding, age and male sex RM = 870 Surgeries associated with RM were nephrectomy (radical or partial) and radical cystectomy
  1. Abbreviations: AKI acute kidney injury, BMI body mass index, CK creatine kinase, ED emergency department, ICU intensive care unit, NA not available, POS prospective observational study, RM rhabdomyolysis, RS retrospective study