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. 2025 Jan-Dec;67(1):e70107.
doi: 10.1111/ped.70107.

Diagnostic evaluation of hematologic inflammatory markers for earthquake-related crush syndrome in pediatric patients

Fatma Durak  1 , Özlem Tezol  1 , Gülçin Bozlu  2 , Serra Sürmeli Döven  3 , Mehmet Alakaya  4 , Merve Misirlioğlu  4 , Edanur Yeşil  5 , Feryal Karahan  6 , İsa Killi  7
Affiliations

Diagnostic evaluation of hematologic inflammatory markers for earthquake-related crush syndrome in pediatric patients

Fatma Durak et al. Pediatr Int. 2025 Jan-Dec.

Abstract

Background: In order to ensure the early treatment of crush syndrome in emergency departments in times of disaster, there is a need for tools that will accelerate and facilitate the diagnosis. We aimed to assess hematologic inflammatory markers as potential diagnostic indicators of crush syndrome in pediatric patients injured by being trapped under debris in the 2023 Turkey-Syria earthquake.

Methods: This analytical study included 123 pediatric cases with a history of being under debris. Patients were divided into three groups according to serum creatine kinase (CK) values and clinical characteristics at the time of admission: trauma group with a normal CK level (n = 33), crush injury group (n = 30), and crush syndrome group (n = 64). Complete blood count results sent at the time of presentation to the emergency department were analyzed. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), and the aggregate index of systemic inflammation (AISI) were calculated.

Results: The median NLR, MLR, SII, SIRI, and AISI were significantly higher in the crush syndrome group compared to both the normal CK and crush injury groups (p < 0.001). According to receiver operating characteristic curve analysis performed for distinguishing between patients with and without crush syndrome, the area under curves of NLR, MLR, PLR, SII, SIRI, and AISI were 0.75, 0.72, 0.63, 0.73, 0.75, and 0.72, respectively.

Conclusions: The use of hematologic inflammatory markers may assist clinicians in making rapid decisions regarding the diagnosis and treatment of crush syndrome in the event of a disaster.

Keywords: crush syndrome; earthquake; neutrophil‐to‐lymphocyte ratio; systemic immune‐inflammation index.

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References

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