Update: Exertional rhabdomyolysis, active component, U.S. Armed Forces, 2014-2018

Area of Science:

• Military Medicine
• Occupational Health
• Exercise Physiology

Background:

• Exertional rhabdomyolysis (ER) is a serious condition involving skeletal muscle breakdown.
• Understanding ER incidence and risk factors in military populations is crucial for prevention and management.

Purpose of the Study:

• To analyze the incidence rates and demographic/occupational risk factors of exertional rhabdomyolysis among active component service members.
• To examine trends in ER diagnoses over a five-year period (2014-2018).

Main Methods:

• Retrospective analysis of incident diagnoses of rhabdomyolysis likely due to ER.
• Calculation of unadjusted incidence rates per 100,000 person-years.
• Subgroup analysis based on demographics (age, sex, race/ethnicity) and military occupation/branch.

Main Results:

• In 2018, 545 cases of ER were diagnosed, with an incidence rate of 42.0 per 100,000 person-years.
• Highest rates in 2018 were observed among males, those under 20, Asian/Pacific Islanders, Marines, Army members, and those in combat roles.
• ER rates generally increased from 2014-2016, with slight fluctuations in 2017-2018. Non-Hispanic blacks had the highest rates except in 2018. Marine Corps members showed the highest rates overall.

Conclusions:

• Exertional rhabdomyolysis poses a significant health risk to active service members, particularly young recruits and those in physically demanding roles.
• Risk stratification and targeted prevention strategies are needed, especially for high-risk subgroups and during intense training periods.
• Medical providers should maintain a high index of suspicion for ER in service members presenting with relevant symptoms after strenuous activity.