Evaluation of Serum Creatinine Phosphokinase Levels and Need of Amputation in Electrical Contact Burns
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Abstract
Background: Increased serum creatinine kinase levels in electric burns can be used as a prognostic indicator with regard to the need for limb amputation.
Aim: To assess serum creatine phosphokinase (CPK) levels in electric burns as a prognostic indicator for limb amputation.
Patients and methods: In patients admitted with electric burns, serum CPK levels were measured serially from the time of admission for 5 occasions. The change in trends of serum levels of CPK levels was studied, and then correlated with amputations among these burn patients.
Results: Most patients belonged to the age group of 16–30 years (40%) and fell in the category of <10% and 11–20% body surface burn (27% each). The highest mean value of CPK levels was on Day 3 - 11639.68 ± 7432.56 U/L. The mean values of CPK were higher in amputated patients. The difference between the two means on all days was significant (p-value<0.05). Pre-gangrenous changes occurred in 35% out of which 33% of patients had to be amputated. Dorsal slit procedure, fasciotomy, and escharotomy were done in 11, 31, and 6% of patients, respectively. The difference in the proportion of patients between the two categories i.e., amputated and non-amputated was statistically significant in which <10% body surface area was affected and 11–20% body surface area was affected (p-value<0.05). In rest all the other classes, the difference was not statistically significant (p-value>0.05).
Conclusion: CPK levels increase in patients with electric burns. The highest mean value was seen on day 3. The mean values of CPK were higher in the patients in which amputation had to be done. Moreover, the difference between the two means on all days i.e., day 1, day 3, day 5, day 7, and day 10 was found to be statistically significant (p-value<0.05).
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