Evaluation of McMahon score for predicting mortality in electrical injury-induced rhabdomyolysis: a retrospective study.
Level 3 - non-randomized controlled study
Retrospective observational cohort study evaluating a prognostic scoring system
PubMed 41910233 · doi:10.1093/postmj/qgag036
What was done
This retrospective observational study analyzed 173 adult patients admitted with electrocution-induced rhabdomyolysis from January 2019 to December 2023. Admission McMahon scores, along with clinical and laboratory variables, were extracted from medical records. Investigators used receiver operating characteristic (ROC) analysis and correlation statistics to assess the score's predictive ability for acute kidney injury (AKI) risk and in-hospital mortality.
What was found
The mean age was 29.4 ± 17.5 years, 80.9% were male, and the median McMahon score was 3.0. In-hospital mortality was 3.5% (~6 patients). Non-survivors had significantly higher McMahon scores than survivors (mean 7.4 vs. 3.4, P < .001). The McMahon score showed an area under the curve of 0.936 (95% CI: 0.876–0.997) for predicting mortality. A cut-off of ≥6 achieved 83.3% sensitivity and 89.2% specificity, and a score of ≥10 had a mortality probability exceeding 90%. McMahon scores strongly correlated with AKI risk percentage (r = 0.998, P < .001).
Why it matters
These results suggest that the McMahon score, originally developed for general rhabdomyolysis, may help emergency clinicians rapidly identify electrocution patients at highest risk for mortality and renal complications.
Limits
The study is limited by its retrospective single-center design and an extremely small number of mortality events (3.5% of 173, or ~6 deaths), creating a high risk of statistical imprecision and overfitting. The abstract provides no data on external validation or post-discharge outcomes.