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2000
Volume 5, Issue 1
  • ISSN: 0250-6882
  • E-ISSN: 0250-6882
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Abstract

Background

Crush syndrome is the second most common cause of death in earthquakes, following direct trauma. Crush syndrome develops when toxic substances released after tissue injury or crushing reach the bloodstream. The aim of this study was to investigate factors associated with morbidity and mortality in patients rescued from the rubble after the February 6 earthquake and admitted to our hospital who had crush syndrome by retrospectively analyzing their data.

Methods

Hemodialysis, fasciotomy, and other parameters during hospitalization and time to transfer to a ward or death of 36 adult patients with crush syndrome who were rescued from the rubble and hospitalized after the February 6 earthquake were retrospectively analyzed.

Results

Thirty-six patients were included in the study. There was no significant correlation between the mortality of patients according to their time of rescue or need for fasciotomy, dialysis, or inotropes (=0.767, =0.294, =0.625, =0.865, respectively). There was a high inverse correlation between the time of rescue and time to death. There was a weak inverse correlation between the time of rescue and hospitalization duration (r=-0.767 and r=-0.341, respectively). There was a significant correlation between the need for inotropes and mortality (p<0.001). No one who didn't need dialysis passed away. Dialysis was necessary for all six of the deceased individuals. We can conclude that one significant factor in predicting death in CS patients is the requirement for dialysis.

Conclusion

Crush syndrome, which develops in patients rescued from the rubble alive, is a life-threatening condition. It is an important syndrome and an important cause of mortality for earthquake victims. Further large-scale studies are needed to elucidate the association of time of rescue, the need for fasciotomy and hemodialysis, and other factors with mortality.

© 2024 The Author(s). Published by Bentham Science Publisher.
This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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2025-09-30

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References

  1. World Health OrganizationTürkiye and Syria earthquakes.Available from: https://www.who.int/europe/emergencies/situations/turkiye-and-syria-earthquakes [Accessed on: March 1].2023
  2. Lists of 21st-century earthquakes/Available from: https://en.wikipedia.org/wiki/Lists_of_21st-century_earthquakes/ 2023
  3. VisionW. Turkey and Syria earthquake FAQs.Available from: https://www.worldvision.org/disaster-relief-news-stories/2023-turkey-and-syria-earthquake-faqs [Accessed on: 23 February 2023].2023
  4. SeverM.S. VanholderR. AshkenaziI. BeckerG. BetterO. CovicA. SmetD.M. EckardtK-U. EknoyanG. GibneyN. HosteE. KazanciogluR. LameireN. LuyckxV. PortillaD. TuglularS. BiesenV.W. Recommendation for the management of crush victims in mass disasters.Nephrol. Dial. Transplant.201227i1i6710.1093/ndt/gfs15622467763
     [Google Scholar]
  5. SeverM.S. VanholderR. Management of crush victims in mass disasters: Highlights from recently published recommendations.Clin. J. Am. Soc. Nephrol.20138232833510.2215/CJN.0734071223024157
     [Google Scholar]
  6. GibneyN.R.T. SeverM.S. VanholderR.C. Disaster nephrology: Crush injury and beyond.Kidney Int.20148551049105710.1038/ki.2013.39224107850
     [Google Scholar]
  7. International Search and Rescue Advisory Group. The medical management of the entrapped person with crush syndrome2023Available from: https://www.insarag.org/wpcontent/uploads/2018/12/ATTACHMENTCThe_Medical_Management_of_the Entrapped_Patient_with_Crush_Syndrome_10_2019 Final.pdf [Accessed on: 17 February 2023].
  8. BywatersE.G. 50 years on: The crush syndrome.BMJ199030167661412141510.1136/bmj.301.6766.14122279155
     [Google Scholar]
  9. GonzalezD. Crush syndrome.Crit. Care Med.2005331S34S4110.1097/01.CCM.0000151065.13564.6F15640677
     [Google Scholar]
  10. SeverM.Ş. ErekE. VanholderR. AkoğluE. YavuzM. ErginH. TekçeM. KorularD. TülbekM.Y. KevenK. VlemV.B. LameireN. The Marmara earthquake: Epidemiological analysis of the victims with nephrological problems.Kidney Int.20016031114112310.1046/j.1523‑1755.2001.0600031114.x11532107
     [Google Scholar]
  11. MichaelsonM. Crush injury and crush syndrome.World J. Surg.199216589990310.1007/BF020669891462627
     [Google Scholar]
  12. BetterO.S. AbassiZ. RubinsteinI. MaromS. WinaverY. SilbermanM. The mechanism of muscle injury in the crush syndrome: Ischemic versus pressure-stretch myopathy.Miner. Electrolyte Metab.19901641811842277600
     [Google Scholar]
  13. SlaterMS Rhabdomyolysis and myoglobinuric renal failure in trauma and surgical patients: A review.J. Am. Coll. Surg.1998186693
     [Google Scholar]
  14. KnochelJ.P. Rhabdomyolysis and myoglobinuria.Annu. Rev. Med.198233143544310.1146/annurev.me.33.020182.0022516282181
     [Google Scholar]
  15. RonD. TaitelmanU. MichaelsonM. JosephB.G. BurszteinS. BetterO.S. Prevention of acute renal failure in traumatic rhabdomyolysis.Arch. Intern. Med.1984144227728010.1001/archinte.1984.003501400770126696564
     [Google Scholar]
  16. ShengZY. Medical support in the Tangshan earthquake: A review of the management of mass casualties and certain major injuries.J. Trauma19872710113011353312621
     [Google Scholar]
  17. OdaY. ShindohM. YukiokaH. NishiS. FujumoriM. AsadaA. Crush syndrome sustained in the 1995 Kobe, Japan, earthquake; treatment and outcome.Ann. Emerg. Med.199730450751210.1016/S0196‑0644(97)70011‑89326866
     [Google Scholar]
  18. VanholderR Kidney problems in disaster situations.Nep Hrol Ther202117SS27S36
     [Google Scholar]
  19. OdaJ Analysis of 372 patients with Crush syndrome caused by the Hanshin-Awaji earthquake.J. Trauma1997423470510.1097/00005373‑199703000‑00015
     [Google Scholar]
  20. BywatersEGL Crush injuries with impairment of renal function.BMJ1941142743210.1136/bmj.1.4185.42720783577
     [Google Scholar]
  21. WangQ. Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in acute pulmonary embolism: A systematic review and meta-analysis.Int. Angiol. J. Int. Union Angiol.2017371411
     [Google Scholar]
  22. ValgaF. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as biological markers of interest in kidney disease.Nefrología2019393243249
     [Google Scholar]
  23. ZhengCF Prognostic value of platelet-to-lymphocyte ratios among critically ill patients with acute kidney injury.Crit. Care20172111110.1186/s13054‑017‑1821‑z
     [Google Scholar]
  24. SalciccioliJD The association between the neutrophil-to-lymphocyte ratio and mortality in critical illness: An observational cohort study.Crit. Care2015191810.1186/s13054‑014‑0731‑6
     [Google Scholar]
  25. HwangSY NeutropHil-to-lympHocyte ratio as a prognostic marker in critically-ill septic patients.Amer. J. Emerg. Med.2017352234239
     [Google Scholar]
  26. KimWH Association between the neutropHil/lympHocyte ratio and acute kidney injury after cardiovascular surgery: A retrospective observational study.Medicine20159443e1867
     [Google Scholar]
  27. YuanY Predictive value of inflammatory factors on contrast‐induced acute kidney injury in patients who underwent an emergency percutaneous coronary intervention.Clin. Cardiol.2017409719725
     [Google Scholar]
  28. BuX Relation of neutrophil-to-lymphocyte ratio to acute kidney injury in patients with sepsis and septic shock: A retrospective study.Int. Immunopharmacol.201970372377
     [Google Scholar]
  29. YuanQ Neutrophil-to-lymphocyte ratio and incident end-stage renal disease in Chinese patients with chronic kidney disease: Results from the Chinese cohort study of chronic kidney disease (C-STRIDE).J. Transl. Med.20191718
     [Google Scholar]
  30. LuX High neutrophil-to-lymphocyte ratio is a significant predictor of cardiovascular and all-cause mortality in patients undergoing peritoneal dialysis.Kidney Blood Press. Res.201843249049910.1159/000488696
     [Google Scholar]
  31. YilmazH Relationship between late arteriovenous fistula (AVF) stenosis and neutropHillympHocyte ratio (NLR) in chronic hemodialysis patients.Ren Fail201436913901394
     [Google Scholar]
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Evaluation of Factors Associated with Mortality in Patients with Crush Syndrome Acquired from the February 6 Kahramanmaras Earthquake
NEW Emirates Medical J 5, e02506882319813 (2024); https://doi.org/10.2174/0102506882319813250106035402
/content/journals/nemj/10.2174/0102506882319813250106035402
/content/journals/nemj/10.2174/0102506882319813250106035402
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  • Article Type:     Research Article
Keyword(s): Crush syndrome; Dialysis; Earthquake; Kahramanmaras; Life-threatening; Mortality

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