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Onan E, Torun D, Kozanoğlu R, Miçözkadıoğlu H, Beyaz S, Özgözen L, Turgut N, Demiroğlu YZ, Karagün Ö, Ergenoğlu P, Kuşçu ÖÖ, Altan E, Güven AT, Abdullayev A, Karluka İ, Yalçın Ç, Mazıcan M, Balcı İG, Özkan B, Parmaksız G, Avcı B, Noyan A, Çolak T, Tünel HA, Temiz A, Gezer HÖ, Erdoğan C, Bairamoi G, Yünlüel D, Çivi S, Durdağ E, Kardeş Ö, Süner Hİ, Tufan K, Erkan S, Avcı T, Gündoğdu R, Kuş M, Fındıkçıoğlu A, Yıldız O, Alışkan E, Coşkunoğlu C, Haberal M. Mortality Factors in Crush Syndrome. ULUS TRAVMA ACIL CER 2024; 30:174-184. [PMID: 38506381 DOI: 10.14744/tjtes.2024.20532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
BACKGROUND Crush 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. METHODS This 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. RESULTS Of 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]). CONCLUSION Our 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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Affiliation(s)
- Engin Onan
- Department of Nephrology, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Dilek Torun
- Department of Nephrology, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Rüya Kozanoğlu
- Department of Nephrology, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Hasan Miçözkadıoğlu
- Department of Nephrology, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Salih Beyaz
- Department of Orthopaedics and Traumatology, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Levent Özgözen
- Department of Orthopaedics and Traumatology, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Necmettin Turgut
- Department of Orthopaedics and Traumatology, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Yusuf Ziya Demiroğlu
- Department of Clinical Microbiology and Infectious Diseases, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Özlem Karagün
- Department of Emergency Medicine, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Pınar Ergenoğlu
- Department of Intensive Care Medicine, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Özlem Özkan Kuşçu
- Department of Intensive Care Medicine, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Ege Altan
- Department of Gastroenterology, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Alper Tuna Güven
- Department of Internal Medicine, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Alim Abdullayev
- Department of Nephrology, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - İsmail Karluka
- Department of Radiology, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Çiğdem Yalçın
- Department of Radiology, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Mustafa Mazıcan
- Department of Radiology, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - İsa Göktürk Balcı
- Department of Radiology, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Burak Özkan
- Department of Plastic and Reconstructive Surgery, Baskent University, Ankara-Türkiye
| | - Gönül Parmaksız
- Department of Pediatric Nephrology, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Begüm Avcı
- Department of Pediatric Nephrology, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Aytül Noyan
- Department of Pediatric Nephrology, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Turan Çolak
- Department of Nephrology, Baskent University, Ankara-Türkiye
| | - Hüseyin Ali Tünel
- Department of Cardiovascular Surgery, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana, Turkey
| | - Abdulkerim Temiz
- Department of Pediatric Surgery, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Hasan Özkan Gezer
- Department of Pediatric Surgery, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Cankat Erdoğan
- Department of Pediatric Surgery, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Galib Bairamoi
- Department of Pediatric Surgery, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Dilek Yünlüel
- Department of Pediatric Surgery, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Soner Çivi
- Department of Neurosurgery, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Emre Durdağ
- Department of Neurosurgery, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Özgür Kardeş
- Department of Neurosurgery, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Halil İbrahim Süner
- Department of Neurosurgery, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Kadir Tufan
- Department of Neurosurgery, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Serkan Erkan
- Department of General Surgery, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Tevfik Avcı
- Department of General Surgery, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Ramazan Gündoğdu
- Department of General Surgery, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Murat Kuş
- Department of General Surgery, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Alper Fındıkçıoğlu
- Department of Thoracic Surgery, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Oya Yıldız
- Department of Thoracic Surgery, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Eda Alışkan
- Department of Microbiology, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Cenk Coşkunoğlu
- Department of Biochemistry, Baskent University Adana Dr. Turgut Noyan Traning and Research Hospital, Adana-Türkiye
| | - Mehmet Haberal
- Department of Transplantation, Baskent University, Ankara-Türkiye
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