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Exertional rhabdomyolysis in newly enrolled cadets of a military academy
Author(s) -
Mao Handing,
Li Xin,
Liu Shuyuan,
Xing Ling,
Zhao Jinbao,
Tan Zhijun,
Sun Hailong,
Song Qing
Publication year - 2021
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.27355
Subject(s) - medicine , rhabdomyolysis , confidence interval , odds ratio , body mass index , hypokalemia , logistic regression , retrospective cohort study , physical therapy
/Aims Exertional rhabdomyolysis (ER) often occurs during prolonged intense exercise in hot environments, posing a threat to the health of military personnel. In this study we aimed to investigate possible risk factors for ER and provide further empirical data for prevention and clinical treatment strategies. Methods A retrospective investigation of 116 concurrent ER cases was conducted. Conditional logistic regression analyses were performed to assess the association between each potential risk (or protective) factor and ER. The clinical characteristics of the 71 hospitalized patients were analyzed descriptively. Results After screening, the following variables significantly increased the risk of ER: shorter length of service (recruits; odds ratios [OR], 7.49; 95% confidence interval [CI], 2.58‐21.75); higher body mass index (BMI; OR, 1.14, 95% CI, 1.03‐1.26); lack of physical exercise in the last half year (less than once per month; OR, 3.20; 95% CI, 1.08‐9.44); and previous heat injury (OR, 2.94; 95% CI, 1.26‐6.89). Frequent fruit consumption (OR, 0.57; 95% CI, 0.33‐0.99), active hydration habit (OR, 0.37; 95% CI, 0.20‐0.67), water replenishment of more than 2 L on the training day (OR, 0.15; 95% CI, 0.05‐0.45), and water replenishment of at least 500 mL within 1 hour before training (OR, 0.33; 95% CI, 0.12‐0.88) significantly decreased the risk of ER. Of the 71 hospitalized patients, 41 (57.7%) were diagnosed with hypokalemia on admission. Discussion In military training, emphasis should be placed on incremental adaptation training before more intense training, and close attention should be given to overweight and previously sedentary recruits. Fluid replenishment before exercise, increased fruit intake, and proper potassium supplementation may help prevent ER.