Retrospective analysis of 116 cases of exertional rhabdomyolysis in newly enrolled cadets of a military academy in Beijing

Abstract

BackgroundExertional rhabdomyolysis (ER) often occurs during prolonged intense exercise in hot environments, posing a threat to the health and safety of military personnel.ObjectiveTo investigate possible risk factors of ER and provide further empirical data for prevention and clinical treatment strategies for ER.MethodsIn this study, a systematic retrospective investigation on 116 concurrent cases of ER was conducted. Demographic, clinical, and exercise-related data were collected from both ER cases and controls which were allotted by 1:3 proportion. Conditional logistic regression analyses were performed to calculate the significance of the association between each potential risk (or protective) factors and ER.ResultsThe adjusted ER prediction model finally included the following variables that significantly increased (or decreased) the risk of acquiring ER: age (odds ratios [OR] 0.59, 95% confidence interval [CI]0.45–0.79), body mass index (BMI, OR 1.11, 95%CI 1.01–1.24), dark-colored urine after training (OR 2.98, 95%CI 1.58–5.64), frequent fruit consumption (OR 0.54, 95%CI 0.29–0.98), active hydrating habit (OR 0.31, 95%CI 1.58–5.64), water replenishment ≥ 2L on the training day (OR 0.18, 95%CI 0.06–0.54), water replenishment ≥ 500 ml within 1 hour before training (OR 0.32, 95%CI 0.11–0.90), lack of physical exercise in the last half-year (OR 3.23, 95%CI 1.34–7.80).ConclusionsIn military training, emphasis should be placed on incremental adaptation training prior to more intense training, and close attention should be paid to overweight and previously sedentary recruits. Fluid replenishment before exercise, increased fruit intake, and proper potassium supplementation may help to prevent ER.