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; epidemiology; football; neiss; overexertion.