Predictive factors for acute kidney injury and amputation in crush injuries from the Kahramanmaraş earthquakes

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dc.authoridKarakaplan, Mustafa/0000-0001-9035-0319
dc.authorwosidKarakaplan, Mustafa/IXN-3318-2023
dc.contributor.authorKoroglu, Muhammed
dc.contributor.authorKarakaplan, Mustafa
dc.contributor.authorBarakat, Mohammed
dc.contributor.authorErgen, Emre
dc.contributor.authorAslanturk, Okan
dc.contributor.authorOzdes, Huseyin Utku
dc.contributor.authorBicakcioglu, Murat
dc.date.accessioned2024-08-04T20:56:12Z
dc.date.available2024-08-04T20:56:12Z
dc.date.issued2024
dc.departmentİnönü Üniversitesien_US
dc.description.abstractBACKGROUND: Crush syndrome (CS) is characterized by high morbidity and mortality due to severe electrolyte disorders, circulatory dysfunction, and multiple organ failure, secondary to severe rhabdomyolysis and reperfusion injuries. Acute kidney injury (AKI) related to crush syndrome is one of the life -threatening complications and is the most frequent cause of death following earthquakes, other than trauma. We conducted a retrospective study to identify predictive parameters from clinical and laboratory data that aid in recognizing CS, assessing its severity, and evaluating acute kidney injury and amputation indications in patients. METHODS: We retrospectively evaluated the clinical data and laboratory follow-up of 33 patients treated for crush syndrome within the first two weeks following the February 6, 2023 earthquake. Patients who underwent surgery for crush syndrome but could not be followed post -surgery were excluded. Laboratory parameters were analyzed upon admission and then daily over an average seven-day follow-up. A p -value of <0.05 was considered statistically significant. Data analysis was performed using IBM SPSS Statistics 26.0 and R Studio software. RESULTS: Of the 33 patients, 17 were male and 16 were female. The incidence of AKI was 35.7%, 66.7%, and 100% in patients with injuries to one, two, and three extremities, respectively. A significant correlation was observed between total entrapment time and the duration of required dialysis days; AKI risk significantly increased with more than six hours of total entrapment time. Regarding the initial blood values upon hospital admission, a myoglobin level exceeding 2330 mg/dL demonstrated the highest sensitivity for predicting AKI. An initial uric acid level (>6.36 mg/dL) on admission had the highest specificity for predicting AKI. The initial myoglobin level (>3450 mg/dL) showed the highest sensitivity in predicting the need for amputation. Meanwhile, the mean creatine kinase (CK) level (>34800 U/L) exhibited the highest specificity but the lowest sensitivity for amputation prediction. CONCLUSION: The study analyzed the effectiveness and predictability of clinical and laboratory findings concerning amputation and acute kidney injury in crush syndrome resulting from earthquakes. Effective amputation management is a crucial factor influencing prognosis and survival in patients with earthquake -induced crush syndrome.en_US
dc.identifier.doi10.14744/tjtes.2024.06228
dc.identifier.endpage509en_US
dc.identifier.issn1306-696X
dc.identifier.issn1307-7945
dc.identifier.issue7en_US
dc.identifier.pmid38967526en_US
dc.identifier.scopus2-s2.0-85197768121en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage500en_US
dc.identifier.urihttps://doi.org/10.14744/tjtes.2024.06228
dc.identifier.urihttps://hdl.handle.net/11616/102103
dc.identifier.volume30en_US
dc.identifier.wosWOS:001265354900006en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherTurkish Assoc Trauma Emergency Surgeryen_US
dc.relation.ispartofUlusal Travma Ve Acil Cerrahi Dergisi-Turkish Journal of Trauma & Emergency Surgeryen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectAcute kidney injuryen_US
dc.subjectamputationen_US
dc.subjectcrush syndromeen_US
dc.subjectearthquakeen_US
dc.titlePredictive factors for acute kidney injury and amputation in crush injuries from the Kahramanmaraş earthquakesen_US
dc.typeArticleen_US

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