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Background <p>The devastating earthquakes in Kahramanmaraş, Türkiye, 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.</p> Methods <p>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.</p> Results <p>The mean age of participants was 42.56 ± 16.92&#xa0;years (Non-survivors: 50.46 ± 20.03&#xa0;years, Survivors: 42.34 ± 16.80&#xa0;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&#xa0;mg/dL vs. 0.77 ± 0.33&#xa0;mg/dL, p = 0.03), with lower eGFR (85.2 ± 34.7&#xa0;mL/min/1.73&#xa0;m² vs. 115.8 ± 39.4&#xa0;mL/min/1.73&#xa0;m², 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&#xa0;mmol/L vs. 5.13 ± 0.98&#xa0;mmol/L, p = 0.008). Regression analysis revealed that pre-earthquake creatinine (HR: 9.121, 95% CI: 2.686–30.970, p &lt; 0.001) and potassium levels at admission (HR: 3.338, 95% CI: 1.540–7.232, p = 0.002) were independent predictors of mortality.</p> Conclusions <p>Pre-earthquake kidney function significantly predicts mortality in crush syndrome patients, highlighting the importance of baseline kidney assessment in disaster preparedness.</p>

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Pre-earthquake kidney function is a predictor of outcomes in earthquake-related crush syndrome

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月8日

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  • Ramazan Daniş,
  • Savaş Öztürk,
  • İsmail Koçyiğit,
  • Jehat Kılıç,
  • Merve Civan,
  • Tuncay Şahutoğlu,
  • Dilek Torun,
  • Engin Onan,
  • Ahmet Alper Kıykım,
  • Simal Köksal Cevher,
  • Gürsel Yıldız,
  • Zeynep Ebru Eser,
  • Fatma Betül Güzel,
  • Süleyman Karaköse,
  • Tolga Yıldırım,
  • Mehmet Polat,
  • Ebru Gök Oğuz,
  • Ali Gürel,
  • Yasemin Coşkun Yavuz,
  • Hasan Kayabaşı,
  • Zehra Eren,
  • Mehmet Rıza Altıparmak,
  • Nurhan Seyahi,
  • Mehmet Küçüksu,
  • Sibel Gökçay Bek,
  • Esra Akçalı,
  • İrem Pembegül,
  • Zeki Aydın,
  • Elif Arı Bakır,
  • Saliha Yıldırım,
  • Sabahat Ecder,
  • Mehmet Horoz,
  • Funda Sarı,
  • Yavuz Ayar,
  • Murat Tuğcu,
  • Ayça İnci,
  • Numan Görgülü,
  • Nedim Yılmaz Selçuk,
  • Gülizar Şahin,
  • Cuma Bülent Gül,
  • Hamat Dheir,
  • Özdem Kavraz,
  • Abdülkadir Ünsal,
  • Sedat Üstündağ,
  • Ali Rıza Odabaş,
  • Serhan Tuğlular

摘要

Background

The devastating earthquakes in Kahramanmaraş, Türkiye, 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 m² vs. 115.8 ± 39.4 mL/min/1.73 m², 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.