Fall patterns and outcomes after a moderate urban earthquake without structural collapse: a retrospective cohort from...

Moderate earthquakes - where structural collapse is absent - represent an underexplored public health challenge. In such events, injuries arise not from building failure but from behavior-associated injury mechanisms. This study aims to characterize injury patterns and mechanisms among individuals presenting to a tertiary emergency department following the 6.2 Mw Istanbul earthquake of April 23, 2025, and to identify implications for community-level behavioral preparedness.

This retrospective study was conducted at a tertiary care hospital serving a catchment population of approximately 750,000 in Istanbul, Turkiye. All individuals presenting to the emergency department within 12 h of the earthquake were included. Cases were identified using the ICD-10 code X34 (earthquake victim). Demographic data, injury mechanisms, anatomical injury sites, need for medical and surgical intervention, and clinical outcomes were recorded. Statistical analysis was performed using IBM SPSS Statistics version 31.0.

A total of 66 individuals were included, representing more than 1/3 of all earthquake-related injuries reported across Istanbul. The mean age was 30.5 ± 13.0 years; 54.5% were male. All recorded injuries were classified as behavior-associated injury mechanisms: same-level falls (W18, 40.9%), falls from stairs (W10, 37.9%), falls or jumps from height (Y30, 12.1%), impact with objects (W22, 6.1%), and entrapment between objects (W23, 3.0%). Injuries coded as W10 and Y30 were significantly more likely to require advanced medical intervention (p < 0.001) and surgical treatment (p = 0.002). The lower extremity was the most commonly affected region (65.2%). Eleven patients (16.7%) required surgical intervention; no deaths occurred.

In this cohort, all recorded injuries were classified as behavior-associated injury mechanisms. These findings suggest that earthquakes without major structural collapse may represent an important and potentially preventable public health burden.