Clinical Significance of Creatine Kinase Elevation in Critically Ill Patients

ABSTRACT

PURPOSE: Creatine kinase (CK) elevation is caused by rhabdomyolysis, intense exercise, muscle damage, and several drugs. This study evaluated the clinical significance of elevated serum CK levels in patients with an intensive care unit (ICU) and their effects on muscle strength. METHODS: The database of 179 patients, who were examined with CK a t least once among patients in the Samsung Medical Center ICU database, was reviewed retrospectively. Forty-eight patients with a myocardial infarction were excluded and 131 patients were analyzed. The clinical features of patients with an elevated CK of more than 2,000 IU/L (more than 10 times the normal value) and those who did not were compared. RESULTS: The ICU stay days were longer in the high elevation group than the other group (8.6 days vs. 21.7 days, p=0.002). The high elevation group was more likely to go to other treatment centers than home after discharge (14.6% vs. 60.0%, p=0.007). When the Medical Research Council scale was measured, the score of the high elevation group was lower than that of the other group (17.2 vs. 13.3, p=0.006). CONCLUSION: Patients with high CK levels were more likely to receive invasive treatment in the ICU, so their muscle strength may decrease with increasing ICU stay and were less likely to be discharged home because of difficulties in living alone. Therefore, in patients with high CK, anticipating long-term treatment in an ICU, minimizing muscle loss, and maintaining functional muscle strength through active rehabilitation will be helpful for the prognosis of the patient.