Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2026
Management of renal failure in earthquake-related crush syndrome: Multicenter intensive care outcomes.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Hatipoğlu Zehra, Doğan Ömer, Gök Mehmet Gökhan, Aydın Kaniye, Güleç Ersel, Türktan Mediha, Çetinkaya Ferhat, Macit Aydın Eda, Tezcan Büşra, Sayın Murat, Akarca Ahu Dudu, Sözütek Didem, Söğüt Akdağ Devrim, Bayrakçı Sinem, Ateş Ayhan Nazire, Ağahan İlhan Asude, Koçak Gamze, Bulut Yüksel Nihal Deniz, Yüksel Deniz, Coşar Ahmet, Yağmurdur Hatice, Tuncer Peker Tülay, Kavrut Öztürk Nilgün, Bayrak Vecihe, Kaya Sedat, Esmaoğlu Aliye, Altay Nuray, Atılgan Serhat, Bayraktar Yeşim Şerife, Sipahioğlu Hilal, Uluç Kamuran, Arslan Yusuf Kemal, Özcengiz Dilek
Аннотация
BACKGROUND: Crush syndrome (CS) is a clinical condition associated with multisystem organ dysfunction that develops after traumatic rhabdomyolysis and primarily affects the kidneys. The aim of this study was to characterize the incidence, risk factors, and treatment patterns of acute kidney injury (AKI) in earthquake victims with CS, with a particular focus on renal replacement therapy (RRT) use and clinical outcomes.
METHODS: In this retrospective multicenter study, 247 adult patients with earthquake-related CS who were admitted to intensive care units (ICUs) in 22 hospitals after the Kahramanmaraş 2023 earthquakes were analyzed. Demographic data, injury patterns, laboratory parameters, treatment protocols, and outcomes were evaluated during the first 15 days following ICU admission.
RESULTS: AKI developed in 78.5% (n=194) of patients, and RRT was required in 62.4% (n=121) of those with AKI. Multiple logistic regression analysis demonstrated that myoglobin and creatinine levels were associated with an elevated risk of developing AKI (odds ratio [OR]: 1.001; 95% confidence interval CI: 1.000-1.001 and OR: 1.735; 95% CI: 1.151-2.615, respectively). Similarly, creatinine level and reasons for ICU admission were identified as factors influencing RRT administration. (OR: 1.7; 95% CI: 1.28-2.15 and OR: 2.9; 95% CI: 1.26-6.90, respectively). The 30-day mortality rate was higher in patients with AKI than in those without AKI. Mortality rates were similar between patients with AKI who received RRT and those who did not.
CONCLUSION: This study demonstrates the high incidence of AKI in earthquake-related CS, underscores the need for improved disaster preparedness with adequate dialysis capacity and early risk stratification using serum myoglobin and creatinine levels for optimal management.
METHODS: In this retrospective multicenter study, 247 adult patients with earthquake-related CS who were admitted to intensive care units (ICUs) in 22 hospitals after the Kahramanmaraş 2023 earthquakes were analyzed. Demographic data, injury patterns, laboratory parameters, treatment protocols, and outcomes were evaluated during the first 15 days following ICU admission.
RESULTS: AKI developed in 78.5% (n=194) of patients, and RRT was required in 62.4% (n=121) of those with AKI. Multiple logistic regression analysis demonstrated that myoglobin and creatinine levels were associated with an elevated risk of developing AKI (odds ratio [OR]: 1.001; 95% confidence interval CI: 1.000-1.001 and OR: 1.735; 95% CI: 1.151-2.615, respectively). Similarly, creatinine level and reasons for ICU admission were identified as factors influencing RRT administration. (OR: 1.7; 95% CI: 1.28-2.15 and OR: 2.9; 95% CI: 1.26-6.90, respectively). The 30-day mortality rate was higher in patients with AKI than in those without AKI. Mortality rates were similar between patients with AKI who received RRT and those who did not.
CONCLUSION: This study demonstrates the high incidence of AKI in earthquake-related CS, underscores the need for improved disaster preparedness with adequate dialysis capacity and early risk stratification using serum myoglobin and creatinine levels for optimal management.