Introduction: Some studies have reported creatinine phosphokinase (CPK) as a new emerging way in predicting the outcomes of poisoned patients. This study aimed to evaluate the association of serum CPK level in the first 24 hours with outcomes of poisoned patients.
Methods: This retrospective cross-sectional study was performed using the medical profiles of poisoned patients aged between 13 and 70 years old who were referred to the emergency department of a big referral medical toxicology center during 6 years and whose necessary data for this study was available.
Results: 318 patients with the mean age of 34.9±14.5 years were studied (77.1% male). The mean serum CPK level of patients was 4693.1 ± 10303.8 (35–89480) IU/L. There was no significant correlation between serum CPK level and cause of poisoning (r= 0.16; p=0.51), age (r = -0.021; p = 0.651), sex (r = 0.131; p = 0.281), seizure (r = -0.022; p = 0.193), level of consciences (r = -0.138; p = 0.167), and duration of hospital stay (r= 0.242, p = 0.437). The mean serum CPK level was significantly higher in ICU admitted (p<0.0001), AKI (p<0.0001), hyperkalemia (p<0.0001), hypophosphatemia (p=0.045), and hypocalcaemia (p=0.008) cases. The best cut off point of serum CPK level in predicting acute kidney injury (AKI) was estimated to be 10000 IU/L (sensitivity = 83.8% and specificity = 68.8%).
Conclusion: It seems that CPK could be considered as a candidate tool for screening the intoxicated patients in need for ICU admission and at risk for AKI.
Asadi R, Afshari R. Ten-year disease burden of acute poisonings in northeast Iran and estimations for national rates. Human & experimental toxicology. 2016;35(7):747-59.
Stewart IJ, Faulk TI, Sosnov JA, Clemens MS, Elterman J, Ross JD, et al. Rhabdomyolysis among critically ill combat casualties: Associations with acute kidney injury and mortality. Journal of Trauma and Acute Care Surgery. 2016;80(3):492-8.
Babak K, Mohammad A, Mazaher G, Samaneh A, Fatemeh T. Clinical and laboratory findings of rhabdomyolysis in opioid overdose patients in the intensive care unit of a poisoning center in 2014 in Iran. Epidemiology and health. 2017;39.
Mural R, Bajaj G, Mammen D. Study of Level of Total Serum Creatine Phosphokinase as Prognostic Indicator in Acute Organophosphorus Poisoning: A Prospective Study. International Journal of Contemporary Medical Research. 2017;4(2):578-82.
Bhattacharyya K, Phaujdar S, Sarkar R, Mullick OS. Serum creatine phosphokinase: A probable marker of severity in organophosphorus poisoning. Toxicology international. 2011;18(2):117.
Deighan CJ, Wong KM, McLaughlin KJ, Harden P. Rhabdomyolysis and acute renal failure resulting from alcohol and drug abuse. QJM : monthly journal of the Association of Physicians. 2000;93(1):29-33.
Hoaken PN, Stewart SH. Drugs of abuse and the elicitation of human aggressive behavior. Addictive behaviors. 2003;28(9):1533-54.
Zutt R, Van Der Kooi A, Linthorst G, Wanders R, De Visser M. Rhabdomyolysis: review of the literature. Neuromuscular Disorders. 2014;24(8):651-9.
Kamal F, Snook L, Saikumar JH. Rhabdomyolysis-Associated Acute Kidney Injury With Normal Creatine Phosphokinase. The American journal of the medical sciences. 2018;355(1):84-7.
Safari S, Yousefifard M, Hashemi B, Baratloo A, Forouzanfar MM, Rahmati F, et al. The value of serum creatine kinase in predicting the risk of rhabdomyolysis-induced acute kidney injury: a systematic review and meta-analysis. Clinical and experimental nephrology. 2016;20(2):153-61.
Hosseini M, Safari S, Sharifi A, Amini M, Farokhi FR, Sanadgol H, et al. Wide spectrum of traumatic rhabdomyolysis in earthquake victims. Acta Medica Iranica. 2009;47(6):459-64.
Hashemi B, Safari S, Hosseini M, Yousefifard M, Erfani E, Baratloo A, et al. A systematic review of Iranian experiences in seismo-nephrology. Archives of trauma research. 2016;5(2).
Eizadi-Mood N, Sabzghabaee AM, Gheshlaghi F, Mehrzad F, Fallah Z. Admission creatine phosphokinase in acute poisoning: is it a predictive factor for the treatment outcome. J Pakistan Med Assoc. 2012;62(3 Suppl 2):S67-70.
Dadpour B, Tajoddini S, Shaarbaf Eidgahi E, Shokouhizadeh M, Shafahi A. Role of Serum Creatinine Phosphokinase in Outcome Prediction of Intoxicated Patients; a Brief Report. Emergency. 2017;5(1):e63.