Comparative study of serum myoglobin versus creatine kinase for evaluation of prognosis after multiple trauma

Abstract

Objective To detect the correlation of serum myoglobin (Mb) and creatine kinase (CK) levels in multiple trauma patients with outcome and renal failure and compare the prognostic value of the two predictors.Methods Forty-one patients with multiple trauma (ISS ≥ 16 points) were analyzed at days 1,3,7,and 14 posttrauma,for serum Mb and CK concentrations.Moreover,simplified acute physiology score Ⅱ (SAPS Ⅱ),injury severity score (ISS),as well as Glasgow coma score (GCS)at day 1 postrauma,final outcome,and presence or absence of renal failure were recorded.Correlation of serum Mb and CK with ISS,GCS,and SAPS Ⅱ was analyzed.Predictive values of Mb and CK for outcome and development of renal failure after multiple trauma were measured and compared at days 1,3,and 7 posttrauma,according to receiver operating characteristic (ROC) curve.Results Serum Mb concentration revealed a positive correlation with SAPS Ⅱ at each time point and with ISS at days 7 and 14,but a negative correlation with GCS at days 3,7,and 14.Similarly,serum CK concentration presented a positive correlation with SAPS Ⅱ at days 3,7,and 14 and with ISS at days 7 and 14,but a negative correlation with GCS at days 7 and 14.To predict outcome of the multiple trauma patients,area under the ROC curve for serum Mb at days 1,3,and 7 was 0.542,0.900,and 0.981 respectively and for serum CK was 0.232,0.771,and 0.968 respectively.To predict development of renal failure,area under the ROC curve for serum Mb at days 1,3,and 7 was 0.864,0.949,and 0.955 respectively and for serum CK was 0.480,0.889,and 0.939 respectively.Conclusions Serum Mb and CK are both predictive of outcome and development of renal failure following multiple trauma.Whereas in co；rast with CK,serum Mb appears to be a more sensitive marker. Key words: Multiple trauma ; Myoglobin ; Creatine kinase ; Kidney failure, chronic