From the Research
Hospitalization is typically required for patients with Creatine Kinase (CK) levels above 50,000 U/L due to the high risk of complications. The decision to hospitalize a patient with elevated CK levels depends on multiple factors, including symptoms, rate of CK rise, kidney function, and underlying cause. Generally, patients with CK levels above 5,000-10,000 U/L warrant closer monitoring, especially if accompanied by signs of rhabdomyolysis, acute kidney injury, electrolyte abnormalities, or severe muscle symptoms 1. Patients with rapidly rising CK levels, regardless of absolute value, may need hospitalization. Management focuses on aggressive IV hydration (typically 200-300 mL/hour initially), electrolyte correction, and treating the underlying cause. Monitoring includes serial CK measurements, kidney function tests, and electrolyte panels. The severity of CK elevation reflects the extent of muscle damage, with higher levels indicating greater risk for complications like acute kidney injury, compartment syndrome, and electrolyte disturbances that may require intensive monitoring and intervention 2. It is essential to note that while CK levels can guide clinical decision-making, they should be considered in the context of the patient's overall clinical presentation and other diagnostic findings 3. In some cases, patients with lower CK levels may still require hospitalization if they exhibit severe symptoms or have underlying conditions that increase their risk of complications 4. Ultimately, the decision to hospitalize a patient with elevated CK levels should be based on a comprehensive assessment of their individual risk factors and clinical needs. Key factors to consider when evaluating the need for hospitalization include the presence of acute kidney injury, electrolyte abnormalities, and severe muscle symptoms, as well as the patient's overall clinical stability and ability to receive adequate care in an outpatient setting 5.