Rhabdomyolysis in older adults: outcomes and prognostic factors

Abstract

Abstract Background : Rhabdomyolysis is a common condition in older persons, often associated with falls. However, prognostic factors of rhabdomyolysis have mainly been studied in middle-aged populations. This study aims to examine whether factors related to 30-day hospital mortality vary with patients’ age. Methods: This single-center retrospective observational study included all patients admitted at the University Hospital of Rennes between 2013 and 2019 whose creatine phosphokinase (CPK) level was greater than five times the normal concentration. The primary endpoint was 30-day in-hospital mortality. Results: 343 patients were included (median age: 75 years). The mean peak CPK was 21.825 IU/L. ; acute renal failure occurred in 57.7% of cases. For patients aged 70 years and over, a long lie after a fall were the main etiology. The in-hospital mortality rate at 30 days was 10.5% (23 deaths). The Charlson score, number of medications, CPK and creatinine levels varied according to age. Age was also a factor that was not proportionally associated with 30-day hospital mortality according to a multivariate analysis. Conclusion: Factors influencing the severity of rhabdomyolysis are not evenly distributed according to age. The term rhabdomyolysis may encompass various clinical realities and be associated with different mechanisms. More research is needed to better understand physiopathological and prognostic factors of rhabdomyolysis, especially in the older population.