Exertional Rhabdomyolysis: A Retrospective Population-based Study

Area of Science:

• Epidemiology
• Sports Medicine
• Nephrology

Background:

• Exertional rhabdomyolysis (ER) is a condition characterized by muscle breakdown due to intense physical activity.
• Understanding the incidence and characteristics of ER in the general population is crucial for public health and clinical management.
• Previous studies have primarily focused on military populations, leaving a gap in knowledge regarding civilian ER occurrence.

Purpose of the Study:

• To determine the incidence rate of exertional rhabdomyolysis (ER) in a population-based cohort.
• To identify the common causes and characteristics of ER in a civilian population.
• To evaluate the complications and outcomes associated with ER.

Main Methods:

• A retrospective cohort study was conducted in Olmsted County, Minnesota, from 2003 to 2015.
• Incident ER cases were identified using the Rochester Epidemiology Project, employing ICD-9 codes and clinical note review.
• Population incidence rates were calculated using census data, with descriptive statistics used for analysis.

Main Results:

• The age- and sex-adjusted incidence rate of ER was 1.06 per 100,000 person-years.
• Common causes included endurance activity (n=7), manual labor (n=5), and weight lifting (n=4).
• Complications were generally mild, including kidney injury (n=5) and electrolyte abnormalities (n=10); most patients were hospitalized briefly and discharged without sequelae.

Conclusions:

• Exertional rhabdomyolysis (ER) occurs infrequently in the civilian population compared to military settings.
• Endurance exercise, manual labor, and weight lifting are primary triggers for ER.
• Conservative management, primarily with intravenous fluids, leads to favorable outcomes with a low recurrence rate.