Introduction: Several mechanisms were introduced as causes of serum creatinine phosphokinase (CPK) raise in intoxicated patients. This study aimed to assess the relationship between serum CPK level in the first 24 hours and baseline characteristics as well as outcomes of these patients.
Methods: This one year retrospective cross-sectional study was conducted on all intoxicated patients, who were admitted to a referral toxicology center, Northwest of Iran, stayed for at least 24 hours and had serum CPK level more than 500 IU/L in the first 24 hours of admission. The relationship between serum CPK level and some baseline and outcome variables were studied using SPSS version 21.
Results: 413 patients with the mean age of 34.52 ± 15.24 years were studied (78.7% male). The mean CPK level at the time of presentation to ED was 3702.85 ± 6375.29 IU/L. There was not any significant relationship between presenting CPK level and type of poisoning (p = 0.258), sex (p = 0.587), and age (p = 0.817). The area under the ROC curve of CPK in prediction of need for dialysis, need for intensive care unit (ICU) admission, and mortality was 0.67 (95% CI: 0.57 – 0.77), 0.60 (95% CI: 0.52 – 0.69), and 0.60 (95% CI: 0.51 – 0.68), respectively.
Conclusion: Based on the finding of present study, there was no significant association between serum CPK level in the first 24 hours and age, sex, and type of poisoning of intoxicated patients and it had poor accuracy in prediction of their need to do dialysis, need for ICU admission, and mortality.
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.
Kaya E, Yilmaz A, Saritas A, Colakoglu S, Baltaci D, Kandis H, et al. Acute intoxication cases admitted to the emergency department of a university hospital. World journal of emergency medicine. 2014;6(1):54-9.
Kidiyoor Y, Rai S, Bakkannavar SM, Nayak VC, James RI, Saravu K. Rhabdomyolysis and strychnine poisoning: A case report. Research Journal of Pharmaceutical, Biological and Chemical Sciences. 2016;7(6):45-7.
Han G, Jang YS, Jang JH, Lim YS, Yang HJ. Risk Factors Associated with Rhabdomyolysis in Acute Carbon Monoxide Poisoning. Journal of Korean Burn Society. 2016;19(2):67-72.
Xue Q, Wang X. A case of rhabdomyolysis, acute renal failure induced by paraquat poisoning. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2015;33(11):855-6.
Eizadi-Mood N, Sabzghabaee A, Gheshlaghi F, Mehrzad F, Fallah Z. Admission creatine phosphokinase in acute poisoning: is it a predictive factor for the treatment outcome? JPMA The Journal of the Pakistan Medical Association. 2012;62(3 Suppl 2):S67-70.
Hoaken PN, Stewart SH. Drugs of abuse and the elicitation of human aggressive behavior. Addictive behaviors. 2003;28(9):1533-54.
Lineberry T, Bostwick J, editors. Methamphetamine abuse: a perfect storm of complications. Mayo Clinic proceedings; 2006.
Deighan C, Wong K, McLaughlin K, Harden P. Rhabdomyolysis and acute renal failure resulting from alcohol and drug abuse. Qjm. 2000;93(1):29-33.
Seham F, Nahla H, Nabil N, Fathia El H, Rania H. Critical Score as a Predictor for Progression of Tramadol Intoxication. Journal of Clinical Toxicology 2015;5(3):249.
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.
Zutt R, van der Kooi A, Linthorst G, Wanders R, de Visser M. Rhabdomyolysis: review of the literature. Neuromuscular disorders: NMD. 2014;24(8):651-9.
Lane R, Phillips M. Rhabdomyolysis. BMJ (Clinical research ed). 2003;327(7407):115-6.
Sinert R, Kohl L, Rainone T, Scalea T. Exercise-induced rhabdomyolysis. Annals of emergency medicine. 1994;23(6):1301-6.
Mousavi S, Vahabzadeh M, Mahdizadeh A, Vafaee M, Sadeghi M, Afshari R, et al. Rhabdomyolysis in 114 patients with acute poisonings. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences. 2015;20(3):239-43.
Talaie H, Pajouhmand A, Abdollahi M, Panahandeh R, Emami H, Hajinasrolah S, et al. Rhabdomyolysis among acute human poisoning cases. Human & experimental toxicology. 2007;26(7):557-61.
Shadnia S, Amiri H, Hassanian-Moghaddam H, Rezai M, Vasei Z, Ghodrati N, et al. Favorable results after conservative management of 316 valproate intoxicated patients. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences. 2015;20(7):656.