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Abstract: TH-PO048

Prognostic Significance of Total Body Surface Area in Rhabdomyolysis Assessed by Bone Scan

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Jung, Sehyun, Gyeongsang National University Hospital, Jinju, Korea (the Republic of)
  • Lee, Seunghye, Gyeongsang National University Hospital, Jinju, Korea (the Republic of)
  • Jang, Hani, Gyeongsang National University Hospital, Jinju, Korea (the Republic of)
  • Kim, Hyun-Jung, Gyeongsang National University Hospital, Jinju, Korea (the Republic of)
  • Bae, Eunjin, Gyeongsang National University Changwon Hospital, Changwon, Gyeongsangnam-do, Korea (the Republic of)
  • Lee, Tae won, Gyeongsang National University Changwon Hospital, Changwon, Gyeongsangnam-do, Korea (the Republic of)
  • Park, Dong Jun, Gyeongsang National University Changwon Hospital, Changwon, Gyeongsangnam-do, Korea (the Republic of)
  • Chang, Se-Ho, Gyeongsang National University Hospital, Jinju, Korea (the Republic of)
Background

Rhabdomyolysis involves skeletal muscle damage. Its severity ranges from asymptomatic enzyme elevation to life-threatening conditions. Bone scans can reveal muscle damage extent and location, aiding diagnosis even with normal biochemical tests. It is important to estimate the total body surface area (TBSA) of the burned area in burn injuries, using the rule of nine and Lund and Browder chart. This study aimed to determine rhabdomyolysis prognosis by applying these tools to muscle damage on bone scans.

Methods

We conducted a retrospective observational study from 2010 to 2022, enrolling 94 rhabdomyolysis patients who underwent bone scans. Cox regression analysis assessed the association between TBSA and all-cause mortality, adjusting for potential confounders.

Results

Applying the rule of nine and Lund and Browder chart to bone scan-assessed muscle damage, TBSA correlated positively with serum BUN, AST, ALT, LDH, and hospitalization length, and negatively with eGFR. Patients with rhabdomyolysis had a higher hazard ratio for all-cause death (HR 1.17; 95% CI 1.04-1.31).

Conclusion

The application of the rule of nine and Lund and Browder chart to bone scans in rhabdomyolysis patients provides a valuable prognostic tool. TBSA correlates with key biochemical markers and clinical outcomes, including mortality. Accurate muscle damage estimation is crucial in managing rhabdomyolysis and improving patient outcomes.

Risk of all-cause death
All Cause DeathlevelsallUnivariable modelMultivariable model
HR (95% CI)P valueHR (95% CI)P value
Rule of nineMean (SD)38.3 (20.8)1.10 (1.03-1.17)0.0041.17 (1.04-1.31)0.008
Sex (male) 60 (63.8%)0.25 (0.04-1.37)0.11014.56 (0.55-385.57)0.109
AgeMean (SD)51.7 (21.2)1.02 (0.99-1.06)0.2571.03 (0.97-1.10)0.313
BMIMean (SD)24.1 (3.8)0.88 (0.68-1.13)0.3140.65 (0.37-1.13)0.128

BMI, body mass index