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Demographic and Clinical Characteristics of Earthquake Victims Presented to the Emergency Department with and without Crush Injury upon the 2023 Kahramanmaraş (Turkey) Earthquake

Published online by Cambridge University Press:  27 September 2023

Çağrı Safa Buyurgan Open the ORCID record for Çağrı Safa Buyurgan [Opens in a new window] ,
Seyran Bozkurt Babuş Open the ORCID record for Seyran Bozkurt Babuş [Opens in a new window] ,
Akif Yarkaç Open the ORCID record for Akif Yarkaç [Opens in a new window] ,
Ataman Köse Open the ORCID record for Ataman Köse [Opens in a new window] ,
Halil Oktay Usluer Open the ORCID record for Halil Oktay Usluer [Opens in a new window] ,
Cüneyt Ayrık Open the ORCID record for Cüneyt Ayrık [Opens in a new window] ,
Hüseyin Narcı Open the ORCID record for Hüseyin Narcı [Opens in a new window]  and
Gülhan Orekici Temel Open the ORCID record for Gülhan Orekici Temel [Opens in a new window]
Çağrı Safa Buyurgan*
Affiliation:
Mersin University, Faculty of Medicine, Department of Emergency Medicine, Mersin, Turkey
Seyran Bozkurt Babuş
Affiliation:
Mersin University, Faculty of Medicine, Department of Emergency Medicine, Mersin, Turkey
Akif Yarkaç
Affiliation:
Mersin University, Faculty of Medicine, Department of Emergency Medicine, Mersin, Turkey
Ataman Köse
Affiliation:
Mersin University, Faculty of Medicine, Department of Emergency Medicine, Mersin, Turkey
Halil Oktay Usluer
Affiliation:
Mersin University, Faculty of Medicine, Department of Emergency Medicine, Mersin, Turkey
Cüneyt Ayrık
Affiliation:
Mersin University, Faculty of Medicine, Department of Emergency Medicine, Mersin, Turkey
Hüseyin Narcı
Affiliation:
Mersin University, Faculty of Medicine, Department of Emergency Medicine, Mersin, Turkey
Gülhan Orekici Temel
Affiliation:
Mersin University, Faculty of Medicine, Department of Biostatistics and Medical Informatics, Mersin, Turkey
*
Correspondence: Çağrı Safa Buyurgan Mersin University Medical Faculty Emergency Medicine Department Mersin, Turkey 33343 E-mail: cagribuyurgan88@yahoo.com.tr
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Abstract

Introduction:

Earthquakes are sudden-onset natural disasters that are associated with substantial material damage, resulting in the collapse of built environment with a high rate of mortality, injury, and disability. Crush syndrome, which can be seen after devastating earthquakes, can lead to acute kidney injury (AKI) and patients may require amputation, fasciotomy, and dialysis. Supportive treatment has an important role in the prognosis of these patients.

Study Objective:

The aim of this study was to investigate the demographic and clinical characteristics of traumatic earthquake survivors admitted to the emergency department (ED) of a hospital, which was close to the earthquake zone but not affected by the earthquake, after the February 6, 2023 Kahramanmaraş (Turkey) earthquakes.

Materials and Methods:

This study was conducted by retrospectively analyzing the data of 1,110 traumatized earthquake survivors admitted to the ED of a tertiary care university hospital from February 6th through February 20th, 2023. Age; gender; time of presentation; presence of comorbid diseases; ED triage category; duration of stay under debris; presence of additional trauma; laboratory tests; presence of AKI; presence of crush injury and injury sites; supportive treatment (fluid replacement and intravenous [IV] sodium bicarbonate); need for amputation, dialysis, and fasciotomy; duration of hospitalization; and outcome of ED were evaluated.

Results:

Of the 1,110 traumatic victims in this study, 55.5% were female patients. The mean age of the patients was 45.94 (SD = 16.7) years; the youngest was 18 years old and the oldest was 95 years old. Crush injury was detected in 18.8% and AKI in 3.0% of the patients. Dialysis, amputation, and fasciotomy were required in 1.6%, 2.8%, and 1.4% of the patients, respectively. In total, 29.2% of patients were hospitalized, including 2.9% admitted to the intensive care unit (ICU) and 26.3% to the relevant ward. In total, 0.3% of the patients included in the study died at ED.

Conclusion:

Post-earthquake patients may present with crush injury, AKI may develop, and fasciotomy, amputation, and dialysis may be needed, so hospitals and EDs should be prepared for natural disasters such as earthquakes.

Keywords

acute kidney injurycrush injurydialysisearthquakeemergency department
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 38 , Issue 6 , December 2023 , pp. 707 - 715
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Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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References

Chan, CC, Lin, YP, Chen, HH, et al. A population-based study on the immediate and prolonged effects of the 1999 Taiwan earthquake on mortality. Ann Epidemiol. 2003;13(7):502–508.CrossRefGoogle Scholar
Aoki, N, Nishimura, A, Pretto, EA, et al. Survival and cost analysis of fatalities of the Kobe earthquake in Japan. Prehosp Emerg Care. 2004;8(2):217–222.CrossRefGoogle ScholarPubMed
MacKenzie, JS, Banskota, B, Sirisreetreerux, N, Shafiq, B, Hasenboehler, EA. A review of the epidemiology and treatment of orthopedic injuries after earthquakes in developing countries. World J Emerg Surg. 2017;12:9.CrossRefGoogle ScholarPubMed
Ukai, T. The great Hanshin-Awaji earthquake and the problems with emergency medical care. Ren Fail. 1997;19(5):633–645.CrossRefGoogle ScholarPubMed
Oda, J, Tanaka, H, Yoshioka, T. Analysis of 372 patients with crush syndrome caused by the Hanshin-Awaji earthquake. J Trauma. 1997;42(3):470–476.CrossRefGoogle ScholarPubMed
Better, OS, Stein, JH. Early management of shock and prophylaxis of acute renal failure in traumatic rhabdomyolysis. N Engl J Med. 1990;322(12):825–829.Google ScholarPubMed
Reis, ND, Michaelson, M. Crush injury to the lower limbs. Treatment of the local injury. J Bone Joint Surg Am. 1986;68(3):414–418.CrossRefGoogle Scholar
Slater, MS, Mullins, RJ. Rhabdomyolysis and myoglobinuric renal failure in trauma and surgical patients: a review. J Am Coll Surg. 1998;186(6):693–716.CrossRefGoogle ScholarPubMed
Sever, MS. CRUSH (Crush) Syndrome and Lessons Learned from the Marmara Earthquake (Second Edition). Istanbul: Lebib Yalkın Publications; 2002. https://nefroloji.org.tr/CRUSH%20%28EZ%C4%B0LME%29%20SENDROMU%20VE%20MARMARA%20DEPREM%C4%B0NDEN%20%C3%87IKARILAN%20DERSLER.pdf. Accessed August 16, 2023.Google Scholar
Uz, I, Cetin, M, Songur Kodik, M, Guvenc, E, Karbek Akarca, F, Ersel, M. Emergency department management after the 2020 Aegean Sea-Izmir earthquake. Ulus Travma Acil Cerrahi Derg. 2022;28(3):361–368.Google ScholarPubMed
Tanaka, H, Oda, J, Iwai, A. Morbidity and mortality of hospitalized patients after the 1995 Hanshin-Awaji earthquake. Am J Emerg Med. 1999;17(2):186–191.CrossRefGoogle ScholarPubMed
Peek-Asa, C, Kraus, JF, Bourque, LB. Fatal and hospitalized injuries resulting from the 1994 Northridge earthquake. Int J Epidemiol. 1998;27(3):459–465.CrossRefGoogle ScholarPubMed
Sever, MS, Erek, E, Vanholder, R, et al. The Marmara earthquake: epidemiological analysis of the victims with nephrological problems. Clin Nephrol. 2001;60(3):1114–1123.Google ScholarPubMed
Almeida, MM, Loenhout, JDFV, Thapa, SS, et al. Clinical and demographic profile of admitted victims in a tertiary hospital after the 2015 earthquake in Nepal. PloS One. 2019;14(7):e0220016.CrossRefGoogle Scholar
Wolfson, N. Amputations in natural disasters and mass casualties: staged approach. Int Orthop. 2012;36(10):1983–1988.CrossRefGoogle ScholarPubMed
Van der Tol, A, Hussain, A, Sever, MS, et al. Impact of local circumstances on outcome of renal casualties in major disasters. Nephrol Dial Transplant. 2009;24(3):907–912.CrossRefGoogle ScholarPubMed
Vanholder, R, Sever, MS, De Smet, M, Erek, E, Lameire, N. Intervention of the renal disaster relief task force in the 1999 Marmara, Turkey earthquake. Kidney Int. 2001;59(2):783–791.CrossRefGoogle ScholarPubMed
Sever, MS, Erek, E, Vanholder, R, et al. Lessons learned from the Marmara disaster: time period under the ruble. Crit Care Med. 2002;30(11):2443–2449.CrossRefGoogle Scholar
Bonomini, M, Stuard, S, Dal Canton, A. Dialysis practice and patient outcome in the aftermath of the earthquake at L’Aquila, Italy, April 2009. Nephrol Dial Transplant. 2011;26(8):2595–2603.CrossRefGoogle ScholarPubMed
Gul, A, Andsoy, II. Performed surgical interventions after the 1999 Marmara earthquake in Turkey, and their importance regarding nursing practices. J Trauma Nurs. 2015;22(4):218–222.CrossRefGoogle ScholarPubMed
Zhang, L, Fu, P, Wang, L, et al. The clinical features and outcome of crush patients with acute kidney injury after the Wenchuan earthquake: differences between elderly and younger adults. Injury. 2012;43(9):1470–1475.CrossRefGoogle ScholarPubMed
Sever, MS, Erek, E, Vanholder, R, et al. Renal replacement therapies in the aftermath of the catastrophic Marmara earthquake. Kidney Int. 2002;62(6):2264.CrossRefGoogle ScholarPubMed