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The Evaluation of Different Treatment Approaches in Patients With Earthquake-Related Crush Syndrome
Background: On February 6, 2023, an earthquake occurred in Kahramanmaras, Turkey, resulting in loss of life, injuries, and the displacement of thousands of people. The aim of this study is to determine the factors affecting amputation and fasciotomy decisions in patients with crush syndrome, along w...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10580897/ https://www.ncbi.nlm.nih.gov/pubmed/37854473 http://dx.doi.org/10.7759/cureus.47194 |
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author | Koyuncu, Sümeyra Sipahioglu, Hilal Bol, Oğuzhan İlik, Hatice Kübra Zenger Dilci, Aslıhan Elmaağaç, Merve Yalçınkaya, Merve Gencer, Vedat Ozan, Fırat Günal, Ali İhsan Kocyigit, Ismail |
author_facet | Koyuncu, Sümeyra Sipahioglu, Hilal Bol, Oğuzhan İlik, Hatice Kübra Zenger Dilci, Aslıhan Elmaağaç, Merve Yalçınkaya, Merve Gencer, Vedat Ozan, Fırat Günal, Ali İhsan Kocyigit, Ismail |
author_sort | Koyuncu, Sümeyra |
collection | PubMed |
description | Background: On February 6, 2023, an earthquake occurred in Kahramanmaras, Turkey, resulting in loss of life, injuries, and the displacement of thousands of people. The aim of this study is to determine the factors affecting amputation and fasciotomy decisions in patients with crush syndrome, along with clinical laboratory parameters. Materials and methods: The study included patients over 18 years of age who presented with crush injuries and exhibited systemic symptoms. Inclusion criteria comprised patients with creatine kinase (CK) levels exceeding 1,000 IU/L, oliguria (urine output less than 400 mL per day), elevated blood urea nitrogen (BUN) levels surpassing 40 mg/dL, serum creatinine exceeding 1.5 mg/dL, potassium levels over 6 mEq/L, phosphorus levels surpassing 8 mg/dL, and serum calcium levels below 8 mg/dL. Multiple parameters were evaluated, including blood glucose, serum sodium, potassium, calcium, phosphorus, BUN, creatinine, uric acid, CK, albumin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, direct bilirubin, prothrombin time (international normalized ratio (INR)), urinalysis, C-reactive protein (CRP), venous blood gas, ECG, and chest radiography. Results: Following the Maraş earthquake, a total of 3,184 patients were admitted to our hospital within the first seven days. Out of these patients, 2,216 received outpatient treatment, 639 were hospitalized in the general ward, and 128 were admitted to the intensive care unit. Among the admitted patients, 237 were diagnosed with crush syndrome, with 126 being male and 111 being female. The average duration of being trapped under debris was eight hours, ranging from four to 36 hours. In the study population, extremity trauma was observed in 84 patients, thoracic trauma in 32 patients, and abdominal trauma in 20 patients. Erythrocyte replacement was administered to 123 patients, while fresh frozen plasma was given to 69 patients, for a total of 1008 units utilized. Mannitol infusions were provided to 58 patients, while bicarbonate infusions were administered to 116 patients. Among the cohort, 71 patients underwent dialysis, with nine of them receiving hemodialysis along with mannitol. Additionally, 67 patients experienced stage 3 acute kidney injury, and 41 patients were deceased. None of the patients required permanent hemodialysis. Conclusion: Earthquakes are considered to be one of nature’s most significant and inevitable disasters. While it is impossible to prevent them, effective management strategies are crucial in mitigating the ensuing chaos and reducing casualties. In order to achieve this, it is imperative to draw lessons from past seismic events and apply appropriate treatment protocols to the affected individuals. |
format | Online Article Text |
id | pubmed-10580897 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-105808972023-10-18 The Evaluation of Different Treatment Approaches in Patients With Earthquake-Related Crush Syndrome Koyuncu, Sümeyra Sipahioglu, Hilal Bol, Oğuzhan İlik, Hatice Kübra Zenger Dilci, Aslıhan Elmaağaç, Merve Yalçınkaya, Merve Gencer, Vedat Ozan, Fırat Günal, Ali İhsan Kocyigit, Ismail Cureus Internal Medicine Background: On February 6, 2023, an earthquake occurred in Kahramanmaras, Turkey, resulting in loss of life, injuries, and the displacement of thousands of people. The aim of this study is to determine the factors affecting amputation and fasciotomy decisions in patients with crush syndrome, along with clinical laboratory parameters. Materials and methods: The study included patients over 18 years of age who presented with crush injuries and exhibited systemic symptoms. Inclusion criteria comprised patients with creatine kinase (CK) levels exceeding 1,000 IU/L, oliguria (urine output less than 400 mL per day), elevated blood urea nitrogen (BUN) levels surpassing 40 mg/dL, serum creatinine exceeding 1.5 mg/dL, potassium levels over 6 mEq/L, phosphorus levels surpassing 8 mg/dL, and serum calcium levels below 8 mg/dL. Multiple parameters were evaluated, including blood glucose, serum sodium, potassium, calcium, phosphorus, BUN, creatinine, uric acid, CK, albumin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, direct bilirubin, prothrombin time (international normalized ratio (INR)), urinalysis, C-reactive protein (CRP), venous blood gas, ECG, and chest radiography. Results: Following the Maraş earthquake, a total of 3,184 patients were admitted to our hospital within the first seven days. Out of these patients, 2,216 received outpatient treatment, 639 were hospitalized in the general ward, and 128 were admitted to the intensive care unit. Among the admitted patients, 237 were diagnosed with crush syndrome, with 126 being male and 111 being female. The average duration of being trapped under debris was eight hours, ranging from four to 36 hours. In the study population, extremity trauma was observed in 84 patients, thoracic trauma in 32 patients, and abdominal trauma in 20 patients. Erythrocyte replacement was administered to 123 patients, while fresh frozen plasma was given to 69 patients, for a total of 1008 units utilized. Mannitol infusions were provided to 58 patients, while bicarbonate infusions were administered to 116 patients. Among the cohort, 71 patients underwent dialysis, with nine of them receiving hemodialysis along with mannitol. Additionally, 67 patients experienced stage 3 acute kidney injury, and 41 patients were deceased. None of the patients required permanent hemodialysis. Conclusion: Earthquakes are considered to be one of nature’s most significant and inevitable disasters. While it is impossible to prevent them, effective management strategies are crucial in mitigating the ensuing chaos and reducing casualties. In order to achieve this, it is imperative to draw lessons from past seismic events and apply appropriate treatment protocols to the affected individuals. Cureus 2023-10-17 /pmc/articles/PMC10580897/ /pubmed/37854473 http://dx.doi.org/10.7759/cureus.47194 Text en Copyright © 2023, Koyuncu et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Internal Medicine Koyuncu, Sümeyra Sipahioglu, Hilal Bol, Oğuzhan İlik, Hatice Kübra Zenger Dilci, Aslıhan Elmaağaç, Merve Yalçınkaya, Merve Gencer, Vedat Ozan, Fırat Günal, Ali İhsan Kocyigit, Ismail The Evaluation of Different Treatment Approaches in Patients With Earthquake-Related Crush Syndrome |
title | The Evaluation of Different Treatment Approaches in Patients With Earthquake-Related Crush Syndrome |
title_full | The Evaluation of Different Treatment Approaches in Patients With Earthquake-Related Crush Syndrome |
title_fullStr | The Evaluation of Different Treatment Approaches in Patients With Earthquake-Related Crush Syndrome |
title_full_unstemmed | The Evaluation of Different Treatment Approaches in Patients With Earthquake-Related Crush Syndrome |
title_short | The Evaluation of Different Treatment Approaches in Patients With Earthquake-Related Crush Syndrome |
title_sort | evaluation of different treatment approaches in patients with earthquake-related crush syndrome |
topic | Internal Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10580897/ https://www.ncbi.nlm.nih.gov/pubmed/37854473 http://dx.doi.org/10.7759/cureus.47194 |
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