The incidence and outcome of rhabdomyolysis among musculoskeletal trauma patients at the University Teaching Hospital, Lusaka

Abstract

Introduction: Rhabdomyolysis is a frequent occurrence among trauma patients, with studies reporting an incidence of as high as 85% (Heurta-Aladin et al. 2004). Other studies however reported an incidence of as low as 6.7 %( Lawrence 2004). The incidence of Acute Kidney Injury (AKI) most studies is about 10 %( Carlos 2004; Ashish 2009, Essam 2010). The syndrome is mostly asymptomatic. Diagnosis is made by measuring creatinine kinase levels in the blood (Huerta-Alardin et al, 2004). Objectives: To determine the incidence and outcome of rhabdomyolysis among trauma patients at UTH. Methods: This was an observational prospective study, conducted in the male and female surgical wards at the University Teaching Hospital. There were a total of 151 trauma patients enrolled. The pattern and extent of injury was recorded and compared to the primary outcome, rhabdomyolysis, which was estimated by measuring the level of serum creatinine kinase. Serum creatine was used as a measure of kidney function. Results: 81.5% of the patients were male and 18.5% were female. The age range was from 19yrs to 75yrs, with a mean age of 34.7years. Motor vehicle accidents accounted for 66.9% of the trauma cases with majority of the injuries occurring in the lower limbs. Rhabdomyolysis was present in 35% of the patients and acute kidney injury in 6%. Rhabdomyolysis was associated with risk of developing renal failure. Conclusion: The incidence of rhabdomyolysis in trauma patients at UTH is 33.6% while that if renal failure was 6%. The greater the injury severity score, the higher the chance of developing rhabdomyolysis and renal failure. With early treatment, trauma induced rhabdomyolysis and renal failure lead to complete recovery.