Exertional rhabdomyolysis in newly enrolled cadets of a military academy.

Han-Ding, Mao; Xin, Li; Shu-Yuan, Liu; Ling, Xing; Jin-Bao, Zhao; Zhi-Jun, Tan; Hai-Long, Sun; Qing, Song

INTRODUCTION/AIMS Exertional rhabdomyolysis (ER) often occurs during prolonged intense exercise in hot environments, posing a threat to the health of military personnel. This study aimed to investigate possible risk factors for ER and provide further empirical data for prevention and clinical treatment strategies. METHODS A retrospective investigation of 116 concurrent ER cases was conducted. Conditional logistic regression analyses were performed to assess the association between each potential risk (or protective) factor and ER. The clinical characteristics of the 71 hospitalized patients were analyzed descriptively. RESULTS After screening, the following variables significantly increased the risk of ER: shorter length of service (recruits, odds ratios [OR] 7.49, 95% confidence interval [CI] 2.58-21.75), higher body mass index (BMI, OR 1.14, 95%CI 1.03-1.26), lack of physical exercise in the last half year (< once a month, OR 3.20, 95%CI 1.08-9.44), and prior heat injury (OR 2.94, 95%CI 1.26-6.89). Frequent fruit consumption (OR 0.57, 95%CI 0.33-0.99), active hydration habit (OR 0.37, 95%CI 0.20-0.67), water replenishment ≥2 L on the training day (OR 0.15, 95%CI 0.05-0.45), and water replenishment ≥500 mL within 1 h before training (OR 0.33, 95%CI 0.12-0.88) significantly decreased the risk of ER. Of the 71 hospitalized patients, 41 (57.7%) were diagnosed with hypokalemia on admission. DISCUSSION In military training, emphasis should be placed on incremental adaptation training prior to more intense training, and close attention should be given to overweight and previously sedentary recruits. Fluid replenishment before exercise, increased fruit intake, and proper potassium supplementation may help prevent ER.