BMC nephrology · 2025
McMahon Score as a predictor of mortality in lightning-associated rhabdomyolysis.
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Şen Abdullah, Yaman Mahmut, Ülgüt Şilan Göger, Belek Sema, Günel Berçem Tugay, Durgun Hasan Mansur, Üstündağ Mehmet, Gündüz Ercan, Orak Murat, Güloğlu Cahfer
Аннотация
BACKGROUND: Lightning strikes are rare but potentially fatal environmental events that can lead to rhabdomyolysis through extensive muscle injury. This condition may result in serious complications such as acute kidney injury (AKI) and death. While the McMahon Score is a recognized prognostic tool in trauma-induced rhabdomyolysis, its effectiveness in lightning-related cases remains uncertain. This study aims to evaluate the prognostic utility of the McMahon Score in predicting mortality and the development of AKI in patients presenting with lightning strike-induced rhabdomyolysis.
METHODS: This retrospective cohort study included 66 patients admitted to a tertiary emergency department (ED) after lightning strikes between January 2013 and January 2023. Demographic, clinical, and laboratory data were reviewed. Patients were categorized by McMahon Score (≤ 6 and > 6). Outcomes such as mortality and AKI were compared. Predictive performance was assessed using ROC curve analysis.
RESULTS: The median age was 21 years; 72.7% were male. The overall mortality rate was 21.2%, and AKI incidence was 7.0%. Patients with McMahon Scores > 6 had significantly higher mortality and AKI rates (p < 0.05). The score showed strong predictive power for mortality (AUC: 0.951). A cutoff value of 6 yielded 71.4% sensitivity and 100% specificity.
CONCLUSIONS: The McMahon Score is a reliable tool for predicting mortality and AKI in lightning-induced rhabdomyolysis. Its simplicity and high accuracy make it valuable for rapid risk assessment in emergency settings.
METHODS: This retrospective cohort study included 66 patients admitted to a tertiary emergency department (ED) after lightning strikes between January 2013 and January 2023. Demographic, clinical, and laboratory data were reviewed. Patients were categorized by McMahon Score (≤ 6 and > 6). Outcomes such as mortality and AKI were compared. Predictive performance was assessed using ROC curve analysis.
RESULTS: The median age was 21 years; 72.7% were male. The overall mortality rate was 21.2%, and AKI incidence was 7.0%. Patients with McMahon Scores > 6 had significantly higher mortality and AKI rates (p < 0.05). The score showed strong predictive power for mortality (AUC: 0.951). A cutoff value of 6 yielded 71.4% sensitivity and 100% specificity.
CONCLUSIONS: The McMahon Score is a reliable tool for predicting mortality and AKI in lightning-induced rhabdomyolysis. Its simplicity and high accuracy make it valuable for rapid risk assessment in emergency settings.