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    Patients with crush syndrome and kidney disease: lessons learned from the earthquake in Kahramanmaras,, Türkiye
    (Elsevier Science Inc, 2024) Ozturk, Savas; Tuglular, Serhan; Olmaz, Refik; Kocyigit, Ismail; Kibar, Muge Uzerk; Turgutalp, Kenan; Torun, Dilek
    This study investigated in-hospital outcomes and related factors in patients diagnosed with postearthquake crush syndrome after the earthquakes in Kahramanmaras,, T & uuml;rkiye. One thousand twenty-four adult patients diagnosed with crush syndrome were analyzed. and outcomes were collected. A total of 9.8% of patients died during their hospital stay. Nonsurvivors were generally older, more likely to have preexisting chronic kidney disease, and faced more severe injuries and complications, including hypotension-shock, arrhythmias, elevated markers of renal dysfunction, and higher rates of acute kidney injury (AKI) and compartment syndrome. In addition, intensive care unit needs were higher. Multivariate analysis confirmed that age, injury severity, shock, high potassium, uric acid, and lactate levels on admission, development of AKI, compartment syndrome, and intensive care unit admission were significant predictors of mortality. Better disaster preparedness and improved health care infrastructure could be potential explanations for improved in-hospital mortality in the current era, as compared to previous earthquakes.
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    Pre-earthquake kidney function is a predictor of outcomes in earthquake-related crush syndrome
    (Bmc, 2025) Danis, Ramazan; Ozturk, Savas; Kocyigit, Ismail; Kilic, Jehat; Civan, Merve; Sahutoglu, Tuncay; Torun, Dilek
    Background The devastating earthquakes in Kahramanmara & scedil;, T & uuml;rkiye, in February 2024, caused extensive trauma and loss of lives, causing unique challenges in the management of earthquake-related crush syndrome. The current study investigates the prognostic value of pre-earthquake kidney function for mortality prediction in patients diagnosed with crush syndrome. Methods A multi-center retrospective analysis was performed using data from 469 patients treated at 46 nephrology clinics. Pre-earthquake Kidney function, defined by serum creatinine and estimated glomerular filtration rate (eGFR) levels, was obtained from pre-earthquake health records. Clinical findings, laboratory parameters, complications, and survival probabilities were analyzed. Multivariate Cox regression was used to identify independent predictors of in-hospital mortality. Results The mean age of participants was 42.56 +/- 16.92 years (Non-survivors: 50.46 +/- 20.03 years, Survivors: 42.34 +/- 16.80 years (p = 0.172)). The in-hospital mortality rate was 2.8%. Non-survivors exhibited significantly higher pre-earthquake creatinine levels than survivors (1.04 +/- 0.61 mg/dL vs. 0.77 +/- 0.33 mg/dL, p = 0.03), with lower eGFR (85.2 +/- 34.7 mL/min/1.73 m(2 )vs. 115.8 +/- 39.4 mL/min/1.73 m(2 ), p = 0.008). Compared with survivors, non-survivors had higher incidences of AKI (92.3% vs. 61.6%, p = 0.037) and more severe metabolic disturbances, including hyperkalemia (5.41 +/- 1.72 mmol/L vs. 5.13 +/- 0.98 mmol/L, p = 0.008). Regression analysis revealed that pre-earthquake creatinine (HR: 9.121, 95% CI: 2.686-30.970, p < 0.001) and potassium levels at admission (HR: 3.338, 95% CI: 1.540-7.232, p = 0.002) were independent predictors of mortality. Conclusions Pre-earthquake kidney function significantly predicts mortality in crush syndrome patients, highlighting the importance of baseline kidney assessment in disaster preparedness.