RESUMO
BACKGROUND: Rhabdomyolysis (RB) is a syndrome characterised by decomposition of skeletal muscle that could be life threatening, so the identification of biomarkers of its severity could help us in its treatment. Creatine kinase (CK) is usually taken as a reference in patients with RB in order to stratify prognosis, however that is not probably the most effective parameter. AIMS: The present study was designed to analyse the specific features and mortality of patients with RB and the relation between creatinine, CK and mortality. METHODS: Retrospective cohort analysis among patients admitted to San Pedro Hospital in Logroño (Spain) with RB (CK levels higher than 2000 U/L) diagnosed since 1 January 2009 until 31 December 2; 013 522 patients with RB patients diagnosed of RB were collected. The aetiology and the analytical feature (creatinine, CK, calcium, phosphorus, pH and bicarbonate), as well as 30-year mortality, were investigated. RESULTS: Among the 522 patients, there were 138 deaths. Four patients required renal replacement therapy. The most common cause of RB was trauma (29%). Infectious aetiology had the highest mortality (41.2%). The median CK was 3451 u/L (interquartile range 3348), and the mean creatinine at admission was 132.6 umol/L (±110.5). Initial CK levels do not have predictive ability on mortality or renal dysfunction in contrast to initial creatinine values. Each state of acute kidney injury (AKI) increased mortality compared with those who have not presented this renal dysfunction (P < 0.0001). Age, calcium, phosphorus, bicarbonate and pH are associated with AKI. CONCLUSION: Despite being a diagnostic marker for RB, initial CK levels do not predict mortality. However, creatinine initial levels are related to progression to acute renal injury and mortality at 30 days.
Assuntos
Injúria Renal Aguda/mortalidade , Injúria Renal Aguda/urina , Creatinina/urina , Rabdomiólise/mortalidade , Rabdomiólise/urina , Injúria Renal Aguda/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/urina , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Mortalidade/tendências , Valor Preditivo dos Testes , Estudos Retrospectivos , Rabdomiólise/diagnóstico , Espanha/epidemiologiaRESUMO
Intestinal anisakiasis is a disease caused by human infection by Anisakis larva that can be found in undercooked fish that is increasing worldwide. The symptoms, typically abdominal pain, develop within 5-7 days after the fish intake. The diagnosis may be suspected based on common anamnesis (unfrozen fish intake) with abdominal pain or bowel obstruction and confirmed by blood serology. Resective surgery is only used in severe cases.