# Characteristics and outcome of rhabdomyolysis in acute ischemic stroke patients: a 10-year retrospective study

## TL;DR

This study found that patients with both acute ischemic stroke and rhabdomyolysis had worse outcomes, but rhabdomyolysis itself was not an independent risk factor for poor results.

## Contribution

The study identifies key predictors of poor outcomes in patients with both acute ischemic stroke and rhabdomyolysis.

## Key findings

- Patients with rhabdomyolysis had higher rates of comorbidities and acute complications.
- NIHSS score >15, infection, and elevated troponin I were independent predictors of poor outcomes.
- Rhabdomyolysis was not an independent predictor of poor outcomes in multivariable analysis.

## Abstract

While acute ischemic stroke (AIS) and rhabdomyolysis (RML) have been reported to co-occur, their clinical relationship and associated outcomes remain poorly understood. This study aimed to investigate the clinical characteristics and outcomes of patients with concurrent AIS and RML.

A retrospective analysis was conducted on patients admitted to the Department of Neurology from January 2014 to December 2023. The clinical and laboratory indicators, as well as the prognosis at discharge, were assessed.

Among 9,360 AIS patients, 146 with RML (CK > 1,000 U/L) were assigned to the RML group, while 146 without RML formed the control group. Patients with RML had a higher incidence of comorbidities and acute complications, including diabetes (43.15% vs. 26.03%, p = 0.002), coronary heart disease (22.60% vs. 10.96%, p = 0.008), and acute kidney injury (35.36% vs. 5.48%, p < 0.001). Poor outcome (death or discharge against medical advice, DAMA) was significantly higher in the RML group than in controls (28.77% vs. 3.42%, p < 0.001). Multivariable logistic regression identified NIHSS score > 15 (OR = 4.932, 95% CI [1.902–12.794], p = 0.001), infection (OR = 5.897, 95% CI [1.550–30.112], p = 0.033), and elevated troponin I (>0.03 ng/ml; OR = 3.384, 95% CI [1.185–9.664], p = 0.023) as independent predictors of poor outcomes. However, RML itself was not an independent predictor.

AIS patients with RML exhibited an increased poor outcome rate. While multivariable analysis identified NIHSS score >15, infection, and elevated troponin I as independent predictors, RML was not an independent risk factor. Given the observational design and the co-occurrence with severity markers, these associations should not be interpreted as independent effects of RML. These findings pertain to in-hospital outcomes only. Post-discharge functional endpoints (e.g., 90-day modified Rankin Scale) were not available.