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Lessons learned from the Marmara disaster: Time period under the rubble
Mehmet Sukru Sever1, Ekrem Erek, Raymond Vanholder
1Department of Nephrology, Istambul School pf Medicine, Turkey.
Critical Care Medicine
|November 21, 2002
Summary
Crush syndrome patients rescued after longer durations under rubble showed higher survival rates. Prolonged entrapment was not an adverse prognostic indicator for survival or renal dysfunction.
Area of Science:
- Disaster Medicine
- Trauma Surgery
- Nephrology
Background:
- The 1999 Marmara earthquake caused widespread crush injuries.
- Understanding factors influencing outcomes in crush syndrome is critical for disaster response.
Purpose of the Study:
- To determine the impact of time spent under rubble on morbidity and mortality in crush syndrome patients following the Marmara earthquake.
Main Methods:
- Observational study analyzing data from 539 crush syndrome patients across 35 hospitals.
- Data collected via questionnaires detailing patient demographics and time under rubble.
Main Results:
- Mean time under rubble was 11.7 hours; 97% rescued within 48 hours.
- Longer entrapment correlated with higher survival rates (p=0.07) and increased amputations (p<0.001).
- Victims entrapped >50 hours had lower initial blood urea nitrogen and creatinine levels.
Conclusions:
- Rescue efforts should extend beyond 48 hours, potentially up to 5 days.
- Time under rubble is not a negative prognostic factor for crush syndrome survival or renal issues.
- Patients surviving longer under rubble may have sustained milder injuries.