BACKGROUND: Hemeproteins such as free myoglobin can undergo autoxidation and catalyse lipid peroxidation, increasing oxidative stress. @entity908 phosphokinase (CPK) elevation is a marker for free myoglobin after myocyte damage. Since oxidative injury is a key mechanism of @entity66 , we hypothesised that serum CPK levels correlate with mortality and need for inotropic medication and duration of inotropic support, i.e. shock, among critically injured @entity1 . METHODS: We conducted a retrospective review of 17,847 @entity1 admitted to a single @entity130 Intensive Care Unit over 9 years. 2583 patients with serum CPK levels were included in the analysis. @entity1 data were collected continuously into an electronic ICU repository. Univariate analysis was accomplished using Spearman correlation and the Mann-Whitney U test. Propensity score adjustment models accounting for potential confounders were used to assess the independent effect of CPK level on mortality, need for inotropic support, and duration of inotropic support. RESULTS: Median CPK was significantly higher in @entity1 who died (916 [IQR 332, 2472] vs. 711 [253, 1971], p=0.004) and in those who required inotropic medications (950 [353, 2525] vs. 469 [188, 1220], p<0.001). After adjusting for propensity score and potential confounders the odds of mortality increased by 1.10 (95% CI 1.02-1.19, p=0.020) and the odds of inotropic medication use increased by 1.30 (95% CI 1.22-1.38, p<0.001) per natural log unit increase in CPK. There was a significant association between CPK level and duration of inotropic support (Spearman's rho .237, p<0.001) that remained significant in a propensity score-adjusted model. CONCLUSION: In critically injured patients, elevated serum CPK level is independently associated with mortality, need for inotropic medication, and duration of inotropic support. This study is the first to evaluate the relationship of CPK level and mortality in addition to surrogate measures of shock in a population of critically injured @entity1 . If these associations are verified prospectively, there may be a role for treatment with @entity68480 reductants, such as @entity1443 , to mitigate the effects of @entity881 .

Elevated serum XXXX phosphokinase is associated with mortality and inotropic requirement in critically injured adults.

@entity1 :: ('9606', 'Species') :: ['patients', 'Patient'] @entity66 :: ('MESH:D004194', 'Disease') :: ['injury-related organ dysfunction'] @entity908 :: ('MESH:D003401', 'Chemical') :: ['Creatine'] @entity881 :: ('MESH:D009102', 'Disease') :: ['shock and end-organ dysfunction'] @entity1443 :: ('MESH:D000082', 'Chemical') :: ['paracetamol'] @entity68480 :: ('CHEBI:35137', 'Chemical') :: ['hemeprotein'] @entity130 :: ('MESH:D014947', 'Disease') :: ['Trauma']
@entity908 :: (MESH:D003401,Chemical) :: ['creatine']
