• Yuan-Yu Hsueh, Chung-Lin Chen, and Shin-Chen Pan.
• Department of Surgery, Section of Plastic and Reconstructive Surgery, Institute of Clinical Medicine, National Cheng Kung University Medical College and Hospital, Tainan 70428, Taiwan, ROC.
• Burns. 2011 Jun 1;37(4):673-7.

BackgroundLimb amputation is considered one of the most devastating consequences of electrical injury. Any factors that correlate with the degree of muscle damage can be used to predict the necessity of limb amputation. The aim of this study was to determine the factors that can be used to predict limb amputation in high-voltage electrically injured patients.MethodsEighty-two high-voltage electrically injured patients were admitted to our hospital during a 17-year period. A retrospective analysis of the possible related risk factors between amputation and non-amputation patients was performed.ResultsA total of 68 patients were enrolled for analysis. Thirteen patients underwent limb amputations. Multivariate analysis of the risk factors between amputation and non-amputation groups showed statistical significance for day 1 creatine kinase-isoenzyme MB (CK-MB) level. A serum CK-MB level above 80 ng/ml predicted high risk of limb amputation with high specificity (84%) and sensitivity (77%). Only one patient with a remarkable decrease of creatine kinase (CK) and CK-MB levels after fasciotomy avoided a major limb amputation.ConclusionOur results suggest that CK-MB level is an independent factor for prediction of limb amputation. We suggest that the addition of CK-MB evaluation to clinical symptoms screening may be a valuable method to early detection of muscle damage.Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

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