다발성 외상 후 횡문근융해증 환자에서의 손상초기 급성신부전의 예측인자 = Predicting Factors for Acute Renal Failure Induced by Rhabdomyolysis at the Early Stage of Multiple Trauma

다국어 초록 (Multilingual Abstract)

Background: Acute renal failure(ARF) is a serious complication of rhabdomyolysis after multiple trauma, and may increase morbidity and mortality. The aim of this study was to elucidate predicting factors for the development of ARF induced by rhabdomyolysis at an early stage of multiple trauma.
Methods: This prospective, observational study was conducted at the emergency department of a level I trauma center. Patients with acute multiple trauma, whose plasma levels of creatine phosphokinase(CPK) were higher than 1,000 IU, were included in this study. We excluded patients with any history of myocardial infarction, stroke, underlying renal disease, and/or infectious disease. We collected clinical and laboratory data including age, heart rate, mean arterial blood pressure, injury severity score, serum myoglobin, lactic dehydrogenase, creating phosphokinase, and base excess. Collected data were compared between patients who had ARF and patients who did not have ARF.
Results: Eighty-eight patients were enrolled in this study. Eighteen patients(20.5%) developed ARF. The injury severity score(ISS)(p=0.001), the base excess(p<0.001), CPK(p=0.003), and myoglobin(p<0.001) were higher in patients with ARF than in patient without ARF. Logistic regression analysis revealed that early predictors for ARF were high ISS, high base excess, high CPK, and high myoglobin.
Conclusion: We could identify early predicting factors for acute renal failure induced by rhabdomyolysis, these factors included ISS, serum CPK and myoglobin, and base excess in the arterial blood gas analysis performed at the emergency department.

목차 (Table of Contents)

• Ⅰ.서론
• Ⅱ.대상과 방법
• Ⅲ.결과
• 1.대상 환자들의 일반적 특징(표 1)
• 2.손상유형 및 손상정도(표 2)
• 3.대상 환자들의 내원당시 검사 소견과 변화 양상
• 4.급성신부전의 예측 요소(표 4)
• Ⅳ.고찰
• Ⅴ.결론