Clinical and Laboratory Factors Associated with Renal Complications Following High-Voltage Electrical Burns: A Retrospective Cohort Study
Ebral Yiğit, Ali Riza Karayıl, Hakan AkelmaAbstract
Background
High-voltage electrical burns cause deep tissue injury, rhabdomyolysis, and acute kidney injury (AKI), but factors associated with renal complications are incompletely characterized. We investigated clinical and laboratory characteristics associated with dipstick-defined presumptive myoglobinuria, AKI, and renal replacement therapy (RRT) after high-voltage electrical burns.
Methods
This retrospective cohort included 37 male patients with high-voltage electrical burns (≥1000 V) treated at a tertiary burn center. Demographics, injury severity, outcomes, surgical interventions, and admission and 48-hour laboratory parameters were compared using nonparametric univariable tests. Receiver operating characteristic (ROC) analyses explored the discriminatory performance of selected variables. As 48-hour serum creatinine contributed to AKI ascertainment, it was not considered an independent AKI biomarker.
Results
Dipstick-defined presumptive myoglobinuria was present in 30 patients (81.1%), AKI occurred in 9 (24.3%), and RRT was required in 3 (8.1%). Patients with AKI had greater TBSA and higher CK, serum myoglobin, and troponin I concentrations than patients without AKI. Among variables available at admission, CK showed the highest discrimination for AKI (AUC 0.925, 95% CI 0.822–0.993), followed by troponin I (AUC 0.919, 95% CI 0.814–0.992) and TBSA (AUC 0.907, 95% CI 0.776–0.992). The increase in serum creatinine over 48 hours was considered part of AKI ascertainment rather than an independent diagnostic marker.
Conclusions
Renal complications after high-voltage electrical burns were associated with greater burn severity and more pronounced laboratory abnormalities. Among admission variables, CK, troponin I, and TBSA showed high discriminatory ability for AKI. These findings are exploratory and require confirmation in larger independent cohorts.