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The following is a summary of “Evaluation of severe rhabdomyolysis on day 30 mortality in trauma patients admitted to intensive care: a propensity score analysis of the Traumabase registry,” published in the November 2024 issue of Critical Care by Martinez et al. 

Traumatic rhabdomyolysis (RM), a common condition associated with acute kidney injury and potential organ dysfunction, might increase mortality risk.  

Researchers conducted a retrospective study to examine the causal effect of severe RM (Creatine Kinase (CK) > 5000 U/L) on 30-day mortality in patients with trauma.  

They performed a study in France using the national major trauma registry (Traumabase) from January 1, 2012, to July 1, 2023. All patients admitted to participating major trauma centers were hospitalized in the intensive care unit (ICU), and with CK measurements were included. Confounding variables for 30-day mortality and exposure were used to calculate a propensity score. A doubly robust method with inverse treatment weighting was used to estimate the treatment effect on the treated (ATT). Analyses such as sensitivity analyses were conducted in 2 subgroups: hemorrhagic shock (HS) and traumatic brain injury (TBI).  

The results showed that of 8,592 patients, 1,544 (18.0%) had severe RM, majority were male (78.6%) with a median age of 41 years [IQR 27–58] and a median injury severity score (ISS) of 20 [13–29], primarily from blunt trauma (90.8%). The ATT in the entire cohort was 0.073 [-0.054 to 0.200]. In the HS subgroup (1,311 patients), the ATT was 0.039 [0.014 to 0.063]. No mortality effect was found in the TBI subgroup. Severe RM was linked to more severe trauma and complications during the ICU stay. Mortality from multiorgan failure (39.9% vs 12.4%) and septic shock (2.6% vs 0.8%) were higher in patients with severe RM.  

Investigators concluded that severe RM was not linked to 30-day mortality but was associated with a 4.0% increase in mortality among patients with concurrent HS and significantly contributed to ICU morbidity. 

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-024-05158-w