Abstract: Objective To investigate the etiology, clinical manifestations and prognosis of rhabdomyolysis (RM)in the elderly. Methods The clinical data of RM patients admitted to Jiangsu Province Hospital from July 2016 to October 2023 were retrospectively analyzed, and the patients were divided into the elderly group (≥60 years old, 54 cases) and the non-elderly group (<60 years old, 160 cases).The baseline characteristics, etiological distribution, clinical manifestations, incidence of acute kidney injury (AKI), and 30-day prognosis were compared between the two groups. Results There were no signicant differences in gender, and the levels of uric acid and potassium between the two groups (P>0.05), while the differences in the levels of creatine kinase, hemoglobin, blood urea, serum creatinine, and phosphorus were statistically significant (P<0.01 or P<0.05). The primary risk factors were different between the two groups. In the elderly group, the top three etiologic factors were infection (42.59%), other physical injuries (22.22%) and poisoning (12.96%), while in the non-elderly group, they were strenuous exercise (49.37%), infection (16.25%) and poisoning (10.62%), respectively. There were 32 patients (59.26%) presenting with at least one manifestation of the triad in the elderly group, which was lower than that in the non-elderly group (120 cases, 75.00%), and the difference was statistically significant (P=0.042). The proportion of patients presenting with fever in the elderly group was significantly higher than that in the non-elderly group (25.93% vs 7.50%, P<0.001). The incidence rate of AKI in the elderly group was significantly higher than that in the non-elderly group (59.26% vs 24.38%,P<0.001). A total of 11 patients died within 30 days of hospitalization, including 8 cases of AKI-related death in the elderly group and 1 case in the non-elderly group.Patients with RM and a poor prognosis were significantly associated with concomitant AKI (χ²=0.024,P<0.001), and the 30-day mortality rate of elderly patients with RM complicated with AKI was significantly higher than that of non-elderly patients (χ²=7.993, P=0.005). Conclusions Elderly RM patients differ from non-elderly RM patients in terms of etiology and clinical presentation, and elderly patients are less likely to present with the classic triad, but are more likely to have concomitant AKI and have a worse prognosis.

Key words: aged, rhabdomyolysis, acute kidney injury, prognosis, clinical feature