Evaluation of McMahon score for predicting mortality in electrical injury-induced rhabdomyolysis: a retrospective study.

Abstract

Electrical injuries can lead to extensive tissue damage, particularly rhabdomyolysis, a severe clinical condition resulting from skeletal muscle breakdown. The McMahon score is a validated prognostic model used to predict acute kidney injury (AKI) and in-hospital mortality in rhabdomyolysis. However, its performance in cases specifically induced by electrocution remains unclear. This retrospective observational study evaluated 173 adult patients admitted with electrocution-induced rhabdomyolysis between January 2019 and December 2023. Clinical and laboratory data, including McMahon scores calculated at admission, were extracted from medical records. Patients were categorized based on survival status, and statistical analyses assessed the relationship between McMahon scores and clinical outcomes, particularly mortality and AKI risk. The mean age was 29.4 ± 17.5 years; 80.9% were male. The median McMahon score was 3.0. In-hospital mortality was 3.5%. Patients who died had significantly higher McMahon scores (mean 7.4 vs. 3.4, P < .001). Receiver Operating Characteristic analysis revealed a strong predictive value for the McMahon score in mortality (area under the curve: 0.936; 95% confidence intervals: 0.876-0.997). A cut-off score of ≥6 yielded 83.3% sensitivity and 89.2% specificity. Mortality probability exceeded 90% when the score was ≥10. McMahon score was positively correlated with AKI risk percentage (r = 0.998, P < .001). The McMahon score is a robust prognostic tool for predicting in-hospital mortality in electrocution-induced rhabdomyolysis. A score ≥ 6 indicates increased risk, while lower scores are associated with favorable outcomes. These findings support the use of McMahon scoring for early risk stratification in emergency settings for electrically injured patients.