Introduction Identifying the potential effective factors of rhabdomyolysis-induced acute kidney injury (AKI) is of major importance for both treatment and logistic concerns. The present study aimed to evaluate the value of creatine kinase... more
Introduction Identifying the potential effective factors of rhabdomyolysis-induced acute kidney injury (AKI) is of major importance for both treatment and logistic concerns. The present study aimed to evaluate the value of creatine kinase (CK) in predicting the risk of rhabdomyolysis-induced AKI through meta-analysis. Methods Two reviewers searched the electronic databases of Medline, EMBASE, Cochrane library, Scopus, and Google Scholar. Data regarding study design, patient characteristics, number of cases, mean and screening characteristics of CK, and final patient outcome were extracted from relevant studies. Pooled measures of standardized mean difference, OR, and diagnostic accuracy were calculated using STATA version 11.0. Result 5997 non-redundant studies were found (143 potentially relevant). 27 articles met the inclusion criteria but 9 were excluded due to lack of data. The correlation between serum CK and AKI occurrence was stronger in traumatic cases (SMD = 1.34, 95 % CI = 1.25–1.42, I 2 = 94 %; p \ 0.001). This correlation was more prominent in crush-induced AKI (adjusted OR = 14.7, 95 % CI = 7.63–28.52, I 2 = 0.0 %; p = 0.001). Area under the ROC curve of CK in predicting AKI occurrence was 0.75 (95 % CI = 0.71–0.79). Conclusion The results of this meta-analysis declared the significant role of rhabdomyolysis etiology (traumatic/non-traumatic) in predictive performance of CK. There was a significant correlation between mean CK level and risk of crush-induced AKI. The pooled OR of CK was considerable , but its screening performance characteristics were not desirable.
To evaluate the initial workup and design a score that would allow ruling out significant intra-abdominal organ injuries following blunt abdominal traumas (BAT).Data were collected prospectively from 147 consecutive patients admitted for... more
To evaluate the initial workup and design a score that would allow ruling out significant intra-abdominal organ injuries following blunt abdominal traumas (BAT).Data were collected prospectively from 147 consecutive patients admitted for BAT in a tertiary care hospital, over a 30-month period.Statistical significance of various parameters (trauma mechanism, clinical examination, laboratory tests, and ultrasound findings) were analyzed in relation to intra-abdominal injuries. The 10 parameters with the best negative predictive values (NPV) were then used to build a score (BATiC). The following points were attributed for these items: abnormal abdominal Doppler ultrasound (4 points), abdominal pain (2 points), peritoneal irritation (2 points), hemodynamic instability (2 points), aspartate aminotransferase >60 IU/L (2 points), alanine aminotransferase >25 IU/L (2 points), white blood cell count >9.5 g/L (1 point), LDH >330 IU/L (1 point), lipase >30 IU/L (1 point), and creatinine >50 μg/L (1 point). A score of ≤7 has a NPV of 97% and includes 67% of the studied population.These results suggest that in hemodynamically stable patients with a normal abdominal Doppler ultrasound and a BATiC score of ≤7, intra-abdominal lesions are very unlikely, and systematic CT scan or hospital admission may be avoided.
