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Creatine kinase as a prognostic indicator in electrical injury
D H Ahrenholz1, W Schubert, L D Solem
1Burn Center, St. Paul Ramsey Hospital, Minn. 55101.
Surgery
|October 1, 1988
Summary
Elevated creatine kinase (CK) and CK-MB levels in electrical burn patients correlate with longer hospital stays and increased risk of skin grafts or amputations. Clinical myocardial infarction is rare and not solely diagnosed by CK-MB levels.
Area of Science:
- Biochemistry
- Cardiology
- Burn Surgery
Background:
- Electrical burn injuries can cause significant tissue damage.
- Monitoring cardiac enzyme levels like creatine kinase (CK) and CK-MB is crucial in assessing burn patient outcomes.
Purpose of the Study:
- To investigate the correlation between serial serum CK and CK-MB levels and clinical outcomes in electrical burn patients.
- To determine the incidence of clinical myocardial infarction (MI) in relation to elevated cardiac enzyme levels.
Main Methods:
- Serial serum CK and CK-MB levels were measured in 116 electrical burn patients.
- Patients were grouped based on peak CK levels within 2 days of admission.
- Clinical MI was diagnosed using ECG, LDH isoenzymes, and clinical course.
Main Results:
- Higher CK and CK-MB levels were associated with significantly longer hospital stays, increased need for skin grafts, and higher rates of limb/digit amputations.
- Only three clinical MIs were identified, all in the highest CK group.
- Elevated CK-MB (>4%) was observed in a substantial proportion of patients with higher CK levels, but did not always indicate clinical MI.
Conclusions:
- Highly elevated CK and CK-MB levels in electrical burn patients are indicators of severe injury, predicting longer hospitalization and greater risk of complications like skin grafting or amputation.
- Clinical myocardial infarction is infrequent in electrical burn patients and cannot be reliably diagnosed by elevated CK-MB levels alone.