Study of the Relationship Between Liver Function Markers and Traumatic Rhabdomyolysis: A Retrospective Study of Hemorrhagic Patients Admitted to Intensive Care Unit in a Level I Trauma Center

Martinez, T; Liaud-Laval, G; Laitselart, P; Pissot, M; Chrisment, A; Ponsin, P; Duranteau, O; De Rudnicki, S; Boutonnet, M; Libert, N

doi:10.1213/ane.0000000000006406

Trauma & major bleeding

Study of the Relationship Between Liver Function Markers and Traumatic Rhabdomyolysis: A Retrospective Study of Hemorrhagic Patients Admitted to Intensive Care Unit in a Level I Trauma Center

Anesth AnalgPublished 14 Apr 2023Retrospective observational study

Main finding · Correlation of log-CK with liver biomarkers; liver failureResultOdds ratio 4.51 CI 1.11–19.2

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Authors' conclusion

Our study established the presence of an association between trauma-related RM and classical hepatic biomarkers. Liver failure was associated with the presence of intense RM in bivariate and multivariable analysis.

Study context

Population: Severely injured hemorrhagic trauma patients transfused within 24 hours and admitted to intensive care unit (ICU), January 2015 to June 2021; significant direct liver injury (abdominal AIS >3) excluded
Participants: 272 participants

Exposure: Intense rhabdomyolysis (RM) vs no intense RM
Intense RMn = 55
Outcome: Relationship between liver function (liver biomarkers; liver failure: Prothrombin time (PT)-ratio <50% and alanine transferase (ALT) >500 U/L) and RM

Methodological detailssingle-centre, level 1 trauma center

Single-centre
Level 1 trauma center

Main finding

As reported in the abstract

Correlation of log-CK with liver biomarkers; liver failure

Odds ratio

4.51

CI 1.11–19.2

P = 0.034

By group

Intense RM18.2%

No intense RM4.6%

Intense RM vs No intense RM

OR 4.51 (CI 1.11–19.2); P = 0.034

Log-CK vs log-AST, r: 0.625
Log-CK vs log-ALT, r: 0.507
Log-CK vs log-bilirubin, r (minimal): 0.262

Observational data: associations, not effects.

Further findings

ICU LOS

P < 0.001

Intense RM7 daysIQR 4–18

No intense RM4 daysIQR 2–11

Correlation of log-CK with liver biomarkers

Log-CK vs log-AST (r): 0.625
Log-CK vs log-ALT (r): 0.507
Log-CK vs log-bilirubin (r), minimal: 0.262

All P < .001

RRT use

Increased RRT use in intense RM patients (4.1% vs 20.0%, P < .001)

Transfusion requirements

Increased transfusion requirements in intense RM patients

Original publication

Study of the Relationship Between Liver Function Markers and Traumatic Rhabdomyolysis: A Retrospective Study of Hemorrhagic Patients Admitted to Intensive Care Unit in a Level I Trauma Center. Anesth Analg. Published 14 April 2023. doi:10.1213/ane.0000000000006406

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