Mortality Factors in Crush Syndrome

Area of Science:

• Emergency Medicine
• Trauma Surgery
• Nephrology

Background:

• Crush Syndrome is a severe complication of earthquakes, leading to significant morbidity and mortality.
• Current knowledge is limited due to a lack of randomized controlled trials, relying heavily on expert experience.
• The 2023 Pazarcik and Elbistan earthquakes provide a critical dataset for studying Crush Syndrome.

Purpose of the Study:

• To analyze the epidemiological and demographic characteristics of earthquake victims with Crush Syndrome.
• To investigate clinical outcomes, including acute kidney injury (AKI) and mortality rates.
• To identify key factors influencing mortality in Crush Syndrome patients.

Main Methods:

• A cross-sectional, observational, retrospective study of 610 earthquake victims.
• Inclusion of 128 patients diagnosed with Crush Syndrome.
• Analysis of hospital records and national registries, with regression analysis for mortality factors.

Main Results:

• The study included 128 Crush Syndrome patients (100 adults, 28 children), with 64 females.
• Acute kidney injury (AKI) occurred in 32.8% of patients, with 69% requiring hemodialysis.
• Low systolic blood pressure on admission was the sole significant predictor of mortality (HR: 1.088, p=0.021).

Conclusions:

• Low systolic blood pressure is a critical risk factor for mortality in earthquake-related Crush Syndrome.
• Emphasizes the need for vigilant blood pressure monitoring, even under rubble.
• Suggests aggressive fluid therapy for patients presenting with hypotension.