Relationship between creatine kinase and liver enzymes in war wounded with rhabdomyolysis
| Autor: | Stéphane De Rudnicki, Nicolas Libert, Jean-Louis Daban, Philippe Laitselart, Jean Derely |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Gastroenterology Rhabdomyolysis law.invention law Liver enzyme Internal medicine Humans Medicine Creatine Kinase Elevated bilirubin General Environmental Science biology business.industry Liver Diseases Study Type Acute Kidney Injury medicine.disease Intensive care unit Pathophysiology biology.protein General Earth and Planetary Sciences Creatine kinase business Complication |
| Zdroj: | Injury. 53:166-170 |
| ISSN: | 0020-1383 |
| Popis: | Rhabdomyolysis is a frequent complication in war wounded. Its complex pathophysiology suggests that it not only affects kidneys but also other organs such as the liver. The aim of this study was to evaluate the relationship between creatine kinase (CK) and liver enzymes in war wounded with rhabdomyolysis.War wounded admitted to the intensive care unit of Percy Military Hospital between 2009 and 2017 with a rhabdomyolysis (CK peak1,000 U/L) were included. They were divided in two groups: mild (CK peak10,000 U/L) and severe rhabdomyolysis (CK peak ≥10,000 U/L). Demographic characteristics, peaks in transaminases, alkaline phosphatase (ALP), bilirubin, and CK were recorded. Mann Whitney-U test and, Fisher's exact test were used as appropriate. A Pearson's correlation test was used to determine the correlation between CK and liver enzymes after a log-normal transformation of the data.Fifty-one patients were included (31 in the mild and 20 in the severe rhabdomyolysis group). Patients in the severe rhabdomyolysis group were more likely victims of explosions (85% vs 39%, p = 0.003). The transaminases peak was significantly higher in the severe rhabdomyolysis group (median AST peak 398 (270-944) vs 91 (63-157) U/L, p0.0001, and median ALT peak 106 (77-235) vs 45 (34-71) U/L, p0.0001). Bilirubin and ALP were higher in the severe rhabdomyolysis group (39 (25-49) vs 14(11-23) U/L, p = 0.0031 and 84 (55-170) vs 52 (39-85) U/L, p = 0.0063, respectively). We found a significant positive linear correlation between CK and ALT (r = 0.73, p0.0001), AST (r = 0.89, p0.0001), ALP (r = 0.41, p = 0.0035), and bilirubin (r = 0.37, p = 0.0083).We found a statistically significant positive correlation between CK and liver enzymes in rhabdomyolysis war wounded, indicating that hepatic damage occurs when rhabdomyolysis is severe and associated with elevated bilirubin and ALP. Further studies are needed to confirm this phenomenon and elucidate the pathophysiological mechanism.IV STUDY TYPE: Diagnostic. |
| Databáze: | OpenAIRE |
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