Epidemiology of Exertional Rhabdomyolysis in the United States: Analysis of NEISS Database 2000 to 2019

ABSTRACT

Objective

There have been numerous case series of exertional rhabdomyolysis (ER) but no comprehensive studies investigating the incidence of ER in the civilian athletic population in the United States (US).

Methods

A retrospective review of patients with ER presenting to emergency departments in the US over a 20-year period between 2000 and 2019 was performed using the National Electronic Injury Surveillance System (NEISS) database.

Results

The national estimate of hospital visits in the US for ER during the 20-year period was 40,654 (0.66 per 100,000 population). There was a 10-fold increase in the incidence of ER from the first to the second decade. The odds of ER were 3.77 (95% CI 3.67–3.86, P < .0001) times higher for males (31,921, 78.5%, 1.06 per 100,000) than females (8,733, 21.5%, 0.28 per 100,000) and 3.82 (95% CI 3.71–3.93, P < .0001) higher in African Americans (33.6, 0.93 per 100,000) than white patients (53%, 0.24 per 100,000). American football (3,064, 7.5%) was responsible for 43.9% of the sports-induced ER cases. The majority (67.3%) of ER cases occurred between the ages of 16 and 35 years old. The majority of patients required hospitalization (26,550, 65.3%).

Conclusions

The number of ER cases presenting to emergency departments in the US increased from 2000–2009 to 2010–2019. Young males and African Americans are at highest risk of ER. There was a high rate of hospitalization.

KEYWORDS:

• Exertional rhabdomyolysis
• creatine kinase
• football
• overexertion
• epidemiology
• neiss

Declaration of interest

None.

Acknowledgment

The authors thank Tom Schroeder, Division Director, Hazard and Injury Data Systems, U.S. Consumer Product Safety Commission for guidance with downloading and understanding the statistical design and analysis of the NEISS data.