ArticleEndocrine connections2026
Prevalence and prognostic impact of rhabdomyolysis in adults hospitalized with diabetic ketosis: a 10-year single-center cohort study.
Article in Endocrine connections, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To determine the prevalence and clinical impact of rhabdomyolysis (RML) among adults hospitalized with diabetic ketosis. Design: Ten-year retrospective single-center cohort study. Methods: We reviewed adults admitted with diabetic ketosis, including isolated ketosis and diabetic ketoacidosis (2015-2024). RML was defined as peak creatine kinase >1,000 U/L; patients with confirmed acute myocardial infarction were excluded. The primary endpoint was a composite poor outcome, defined as in-hospital death or discharge against medical advice (DAMA) due to critical illness with a grave prognosis. Predictors of poor outcome were assessed using Firth-corrected multivariable logistic regression. Results: Of 920 eligible patients, 18 (1.96%) developed RML. Compared with controls, patients with RML were older and more likely to have neurological comorbidities, recent falls, impaired consciousness, infection, effective serum osmolality >320 mOsm/kg, leukocytosis, higher C-reactive protein, elevated creatinine, acute kidney injury, markedly raised myoglobin, and elevated troponin I. RML was associated with a longer hospital stay, higher costs, a higher in-hospital mortality (11.1 vs 0.67%), and a higher rate of the composite poor outcome (16.7 vs 1.11%). Leukocytosis (>9.5 × 109/L; adjusted OR: 4.29, 95% CI: 1.35-14.37, P = 0.014) and troponin I > 0.03 ng/mL (adjusted OR: 5.79, 95% CI: 1.56-21.86, P = 0.009) independently predicted poor outcome. Conclusions: RML is an uncommon but important complication of diabetic ketosis, conferring a higher short-term mortality, healthcare use, and composite poor outcome. Routine screening for RML and concurrent inflammatory or cardiac injury provides a crucial window for early risk stratification, enabling clinicians to optimize therapeutic strategies and resource use for high-risk individuals.
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