• Ulus Travma Acil Cerrahi Derg · Mar 2024

    Observational Study

    Mortality Factors in Crush Syndrome.

    • Engin Onan, Dilek Torun, Rüya Kozanoğlu, Hasan Miçözkadıoğlu, Salih Beyaz, Levent Özgözen, Necmettin Turgut, Yusuf Ziya Demiroğlu, Özlem Karagün, Pınar Ergenoğlu, Özlem Özkan Kuşçu, Ege Altan, Alper Tuna Güven, Alim Abdullayev, İsmail Karluka, Çiğdem Yalçın, Mustafa Mazıcan, İsa Göktürk Balcı, Burak Özkan, Gönül Parmaksız, Begüm Avcı, Aytül Noyan, Turan Çolak, Hüseyin Ali Tünel, Abdulkerim Temiz, Hasan Özkan Gezer, Cankat Erdoğan, Galib Bairamoi, Dilek Yünlüel, Soner Çivi, Emre Durdağ, Özgür Kardeş, Halil İbrahim Süner, Kadir Tufan, Serkan Erkan, Tevfik Avcı, Ramazan Gündoğdu, Murat Kuş, Alper Fındıkçıoğlu, Oya Yıldız, Eda Alışkan, Cenk Coşkunoğlu, and Mehmet Haberal.
    • Department of Nephrology, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye.
    • Ulus Travma Acil Cerrahi Derg. 2024 Mar 1; 30 (3): 174184174-184.

    BackgroundCrush Syndrome is a major cause of morbidity and mortality following large-scale catastrophic earthquakes. Since there are no randomized controlled studies on Crush Syndrome, knowledge on this subject is limited to expert experience. The primary objective is to analyze the epidemiological and demographic characteristics, clinical outcomes, and mortality factors of earthquake victims after the Pazarcik and Elbistan earthquakes on February 6, 2023.MethodsThis cross-sectional and observational retrospective study evaluated 610 earthquake victims who presented to our center between February 6 and April 30, 2023. Among these patients, 128 with Crush Syndrome were included in the study. Patient information was gathered from hospital records during their stay and from national registries upon referral. The primary outcome was to identify risk factors for mortality. Demographic and laboratory data were analyzed by acute kidney injury (AKI) stages; mortality-affecting factors were identified through regression analysis.ResultsOf the 128 Crush Syndrome patients (100 adults, 28 children), 64 were female. The AKI rate was 32.8%. Among patients with AKI, the frequency of hemodialysis requirement was 69%, and the mortality rate was 14.2%. The overall mortality rate for patients with Crush Syndrome was 4.6%, compared to 3.9% (19/482) in earthquake victims without Crush Syndrome (p=0.705). Notably, low systolic blood pressure at admission was the only factor significantly affecting mortality in Crush Syndrome patients (Hazard Ratio [HR]: 1.088, p=0.021, 95% Confidence Interval [CI]).ConclusionOur study highlights low systolic blood pressure upon admission as a significant risk factor for increased mortality in Crush Syndrome patients. This finding may contribute to the literature by emphasizing the importance of monitoring blood pressure under rubble and administering more aggressive fluid therapy to patients with low systolic blood pressure.

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