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ENGLISH SUMMARY
Introduction: Overexertion and too much training are among the
multiple etiologies of rhabdomyolysis. Creatine kinase (CK) and myo-
globine, released from skeletal muscle cells, are useful for diagnosis and
follow-up. Acute kidney injury is a serious complication of myoglobine-
mia. Literature on exertional rhabdomyolysis in the general population
is scarce. The aim of this study was to investigate the epidemiology of
exertional rhabdomyolysis among patients diagnosed at Landspítali The
National University Hospital of Iceland in 2008-2012.
Materials and methods: The study was retrospective and observation-
al. All patients presenting with muscle pain after exertion and elevated
creatine kinase >1000 IU/L, during the period from 1 January 2008 to 31
December 2012, were included. Patients with CK elevations secondary
to causes other than exertion were excluded. Variables included: patient
number and gender, CK-levels, date of hospital admission, cause of
rhabdomyolysis, location of injured muscle groups, length of hospital
stay, complications and means of fluid replacement. Population figures
of the capital region were gathered from Statistics Iceland and informa-
tion on sport practice in the capital region from The National Olympic
and Sports Association of Iceland.
Results: Exertional rhabdomyolysis was diagnosed in 54 patients, 18
females (33,3%) and 36 males (66,7%), or 8,3% of rhabdomyolysis cases
from all causes in the study period (648 cases). Incidence in the capital
region was 5,0/100.000 inhabitants per year in the study period. Median
age was 28 years and median CK-level was 24.132 IU/L. CK-levels were
higher among females but the difference between genders was not sig-
nificant. Muscle groups of the upper and lower extremities were most
frequently affected (89%). Thirty patients received intravenous fluids.
They had significantly higher CK values than other patients. One patient
developed acute kidney injury. Information on sport practice and physi-
cal training in the capital region was not available.
Conclusion: Exertional rhabdomyolysis is uncommon but mostly
affects younger people. Information on the practice of exertion among
males and females is not available but CK-levels were not significantly
different between genders, age groups or different muscle groups. CK-
levels were high but complications uncommon. Studies of exertional
rhabdomyolysis in the general population are lacking.
Visits of patients with exertional rhabdomyolysis to the Emergency Department
at Landspítali, The National University Hospital of Iceland in the years 2008-2012
Arnljotur Bjorn Halldorsson1,2, Elisabet Benedikz3, Isleifur Olafsson4, Brynjolfur Mogensen1,2
1Faculty of Medicine, University of Iceland, 2Rsearch Institute in Emergency Medicine, The National University Hospital, 3Department of Quality and Patient Safety, The National Univer-
sity Hospital and 4Department of Clinical Biochemistry, The National University Hospital.
Key words: Rhabdomyolysis, exertion, sports, physical training, CK elevation.
Correspondence: Brynjólfur Mogensen, brynmog@landspitali.is