Rhabdomyolysis in Community Acquired Bacterial Sepsis – A Retrospective Cohort Study 英文参考文献.docVIP

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Rhabdomyolysis in Community Acquired Bacterial Sepsis – A Retrospective Cohort Study 英文参考文献.doc

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Rhabdomyolysis in Community Acquired Bacterial Sepsis – A Retrospective Cohort Study 英文参考文献

Rhabdomyolysis inCommunityAcquiredBacterial Sepsis–ARetrospective CohortStudy AnitaA.Kumar1,EmmanuelBhaskar1,GhanshyamPalamanerSubashShantha1* ,Porchelvan Swaminathan2,GeorgiAbraham3 1Department of General Medicine, Sri Ramachandra University, Tamilnadu, Chennai, India, 2Department of Biostatistics, BrainWave Bio Solutions Ltd, Tamilnadu, Chennai,India,3DepartmentofNephrology,MadrasMedicalMissionHospital,Tamilnadu,Chennai,India Abstract Background and Objectives: Rhabdomyolysis is often associated with sepsis and gram positive bacterial pathogens are reported to be the most frequent cause of sepsis induced rhabdomyolysis. We report the pattern of infecting bacterial pathogensandassociatedcausalfactorsinaSouth-Indiancohort. Design, Setting, Participants Measurements: Retrospective cohort study of adult patients with community acquired bacterial sepsis complicated by rhabdomyolysis from March 2003 - August 2008. Rhabdomyolysis was defined as serum creatinekinase.2000IU/L.Thestudypopulationwasdividedintogroup-I(sepsiswithgrampositivepathogens),group–II (sepsiswithgramnegativepathogens)andgroup-III(culturenegativesepsis). Results:103patients(groupI-15,groupII-34andgroupIII-54)formedthestudycohort.Meanagewas55yearsandtwo- thirdhaddiabetes.Meancreatinekinasewas7114IU/Landmeanserumcreatinineonadmissionwas2.4mg/dl.Causative pathogen of sepsis was identified in 47.5%. Gram negative pathogens were more frequently (33%) associated with rhabdomyolysisthangrampositivepathogens(14.5%).Lungwasthecommonestfociofsepsis(38.8%).78.6%ofthestudy populationhadoneormoreadditionalcausalfactorforrhabdomyolysislikestatinintake,chronicalcoholism,hypokalemia, hypernatremiaandhypophosphatemia.Mortalitywas59%. Conclusions:Gramnegativebacterialpathogensweremorefrequentlyassociatedwithrhabdomyolysisthangrampositive pathogens.Rhabdomyolysisinpatientswithsepsisismultifactorialandisassociatedwithhighmortality. Citation:KumarAA,BhaskarE,PalamanerSubashShanthaG,SwaminathanP,AbrahamG(2009)Rhabdomyol