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McMahon Score for Rhabdomyolysis

The McMahon Score predicts the risk of acute kidney injury, need for renal replacement therapy, or in‑hospital mortality in patients with rhabdomyolysis.

Age, years

≤ 50051-70+1.571-80+2.5> 80+3

Sex

Male0

Female+1

Initial creatinine

< 1.4 mg/dL (124 µmol/L)01.4 - 2.2 mg/dL (124-195 µmol/L)+1.5> 2.2 mg/dL (195 µmol/L)+3

Initial calcium < 7.5 mg/dL (1.88 mmol/L)

No0

Yes+2

Initial CPK > 40,000 U/L

No0

Yes+2

Rhabdo secondary to seizures, syncope, exercise, statins or myositis

Yes0

No+3

Initial phosphate

< 4.0 mg/dL (1.0 mmol/L)04.0 - 5.4 mg/dL (1.0 - 1.4 mmol/L)+1.5> 5.4 mg/dL (1.4 mmol/L)+3

Initial bicarbonate < 19 mEq/L

No0

Yes+2

사용 적응증

Used in adults with confirmed rhabdomyolysis at presentation to estimate risk of AKI requiring RRT or in‑hospital mortality, guiding fluid intensity, monitoring level, and early nephrology involvement. Developed/validated in large cohorts (n=2371; composite outcome 19%) with strong discrimination (C‑statistic 0.82–0.83) 1 [Level II evidence]. A cutoff ≥6 identifies high‑risk patients; scores <5 indicate very low short‑term risk.

통찰 및 주의사항

Stratify risk of AKI, RRT, or mortality using admission age, etiology, creatinine, CPK, phosphate, calcium, and bicarbonate, recognizing high-risk scores (≥6) signal markedly increased adverse outcomes (e.g., 61% risk at >10 in validation cohort) 1 [Level II evidence]. Use cautiously: performance varies by population (AUC ~0.72–0.83 across settings) 2 [Level II evidence], and external validations note reduced calibration in heterogeneous cohorts.