Pediatrics international : official journal of the Japan Pediatric Society · 2025
Diagnostic evaluation of hematologic inflammatory markers for earthquake-related crush syndrome in pediatric patients.
СтатьяНазвание и аннотация: Перевод в очереди
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Durak Fatma, Tezol Özlem, Bozlu Gülçin, Döven Serra Sürmeli, Alakaya Mehmet, Misirlioğlu Merve, Yeşil Edanur, Karahan Feryal, Killi İsa
Аннотация
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.
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.