Early survival and duration of hospital admission in rhabdomyolysis: ICNARC Case Mix Programme Database

Abstract

New therapeutic measures are available for the management of rhabdomyolysis. To enable the design of future studies that will assess the clinical benefi t of these interventions, we sought to fi rst determine the current clinical outcomes of patients with rhabdomyolysis admitted to ICUs within England, Wales and Northern Ireland. We describe the duration of intensive care and hospital admissions associated with rhabdomyolysis, and the early survival measures for this population. Acute kidney injury secondary to high serum myoglobin levels is a frequent cause of morbidity and mortality for patients with rhabdomyolysis [1]. Th eoretically the severity and duration of the tubulointerstitial lesion that results could be reduced if rapid removal of myoglobin from the circulation was undertaken to reduce the tubules’ exposure to myoglobin [2]. Recent case reports have highlighted that dialysis membranes with high molecular weight cut-off points (50 kDa) are able to provide signifi cantly higher clearance rates of myoglobin compared with standard high-fl ux dialysis membranes [3,4]. To determine the clinical benefi t of providing rapid removal of myoglobin in patients with rhabdomyolysis, randomised controlled trials are now required to determine whether the procedure improves outcomes compared with standard care. Possible clinical outcomes for these studies would be the duration of hospital stay, rates of renal recovery and survival. To allow the design of these studies, current clinical outcomes for this population are required. We therefore interrogated a national database to determine the clinical outcomes for patients with rhabdomyolysis admitted to ICUs. Th e Case Mix Programme is the national clinical audit of adult, general critical care units in England, Wales and