Preoperative Assesment of Activity of Muscle-derived Enzymes in Patients with Trauma and Orthopedic Diseases

Preoperative activity of enzymes derived from skeletal muscle (creatine kinase: CK; lactate dehydrogenase: LDH; glutamate oxaloacetic transaminase: GOT) in patients with trauma including fracture (traumatic group) and in non-trumatic patients (control group) were compared. CK activity was lower than 200IU/l in 97.8% of patients in the control group, and only 0.4% higher than 1, 000IU/l. However, the serum CK level in 28.9% and 3.4% of patients was higher than 200IU/l and 1, 000IU/l in the traumatic group. The maximam CK activity was 8, 404IU/l in the traumatic group. CK, LDH, and GOT activity in the traumatic group was higher than in the control group. Activity of these three kinds of enzymes in patients suffering from multiple trauma was higher than in those with single trauma. Patients with trauma in the spine, pelvis, thorax, and abdomen tended to show higher serum muscle-derived enzyme activity than patients with fracture in clavicula or extremities. Of several orthopedic diseases, only patients suffering from spinal cord injury showed higher CK activity than those who underwent general surgery. The mean serum CK level in spinal cord injury patients was 185IU/l, and its maximum was 706IU/l. We concluded that traumatic patients showed high CK activity of up to several thousand IU/l, while patients with spinal cord injury also had high CK activity, but less than 1, 000IU/l.