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Observational Study
. 2024 Dec;37(9):2589-2599.
doi: 10.1007/s40620-024-02051-1. Epub 2024 Sep 25.

Epidemiological analysis of the victıms wıth crush syndrome in earthquakes of southeastern Turkey

Ilyas Ozturk  1 , Ozkan Gungor  2 , Savas Ozturk  3 , Refik Olmaz  4 , Ayse Jini Gunes Keskin  4 , Ismail Kocyigit  5 , Murat Hayri Sipahioglu  5 , Fatih Dede  6 , Sena Ulu  7 , Kenan Turgutalp  8 , Dilek Torun  9 , Tuncay Sahutoglu  10 , Fatih Mehmet Erdur  11 , Orcun Altunoren  2 , Ramazan Danis  12 , Gursel Yildiz  13 , Ali Gurel  14 , Mehmet Horoz  15 , Mehmet Kucuksu  16 , Suleyman Karakose  17 , Tolga Yildirim  18 , Mehmet Riza Altiparmak  19 , Mehmet Deniz Ayli  20 , Murat Tugcu  21 , Zehra Eren  22 , Eray Eroglu  23 , Yasemin Coskun Yavuz  24 , Esra Akcali  25 , Dede Sit  26 , Mehmet Polat  27 , Saliha Yildirim  28 , Selma Alagoz  29 , Sibel Gokcay Bek  30 , Irem Pembegul  31 , Tahsin Karaaslan  32 , Mustafa Keles  33 , Funda Sari  34 , Ustun Yilmaz  35 , Numan Gorgulu  36 , Gulizar Sahin  37 , Zeki Aydin  38 , Serap Yadigar  39 , Ozkan Ulutas  40 , Nedim Yilmaz Selcuk  41 , Yavuz Ayar  42 , Didem Turgut  6 , Ozgur Akin Oto  3 , Mehmet Koc  21 , Alaattin Yıldız  3 , Serhan Tuglular  21 , Mehmet Sukru Sever  3
Affiliations
Observational Study

Epidemiological analysis of the victıms wıth crush syndrome in earthquakes of southeastern Turkey

Ilyas Ozturk et al. J Nephrol. 2024 Dec.

Abstract

Background: Each year, millions face natural disasters, encountering mass fatalities and severe medical issues such as crush injuries and crush syndrome. Crush syndrome, marked by acute kidney injury (AKI) and hyperkalemia, correlates with mortality. This study focuses on presenting epidemiological data on kidney disease resulting from the February 6, 2023 earthquakes centered in Kahramanmaras.

Methods: This retrospective analysis included patients diagnosed with crush syndrome after the 2023 Kahramanmaras earthquakes, treated in regional hospitals or referred elsewhere in Turkey. Patient data were documented using the web-based system developed by the Turkish Nephrology Association Renal Disaster Working Group.

Results: Of the 1024 analyzed patients from 46 centers, 515 (50.3%) were women. The mean age was 41 ± 16 years, with a median duration of 12 h under rubble, and the median presentation time to the first health facility was 4 h after extrication from the rubble. Upon admission, 79.8% received intravenous fluid therapy, all potassium-free. Initial serum creatinine, K+, and creatinine kinase levels averaged 2.59 ± 2 mg/dl, 5.1 ± 1 mmol/L 38,305 ± 54,303 U/L, respectively. Intensive care unit (ICU) admissions were 53.6%, with mean hospital and ICU stays of 20 and 11 days, respectively. Compartment syndrome occurred in 40.8% of patients, with 75.8% undergoing fasciotomy. Acute kidney injury developed in 67.9% of patients, with 70.3% undergoing hemodialysis, totaling 3016 sessions on 488 patients. The overall in-hospital mortality rate was 9.8%.

Conclusion: Earthquakes have a significant impact on kidney health. Although our study indicates some progress compared to previous earthquake responses, there remains a crucial need for drills emphasizing post-earthquake initial response, fluid-electrolyte balance management, and emergency dialysis protocols.

Keywords: Crush syndrome; Disaster; Earthquake; Epidemiology.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no conflict of interest. Ethical approval: The study was conducted in accordance with the Declaration of Helsinki. The study protocol was reviewed and approved by Istanbul University Istanbul Faculty of Medicine Clinical Research Ethics Committee (Decision date/no: 17.02.2023/04). Human and animal rights: This study does not contain any studies with animals performed by any of the authors. Informed consent: For this type of study, formal consent is not required.

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