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2023 年土耳其卡赫拉曼马拉什地震中,有无挤压伤的急诊科地震伤员的人口统计学和临床特征。

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

机构信息

Mersin University, Faculty of Medicine, Department of Emergency Medicine, Mersin, Turkey.

Mersin University, Faculty of Medicine, Department of Biostatistics and Medical Informatics, Mersin, Turkey.

出版信息

Prehosp Disaster Med. 2023 Dec;38(6):707-715. doi: 10.1017/S1049023X23006416. Epub 2023 Sep 27.

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 6 through February 20, 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.

摘要

简介

地震是突发的自然灾害,会造成巨大的物质损失,导致建筑环境崩溃,死亡率、受伤率和残疾率高。毁灭性地震后会出现挤压综合征,可导致急性肾损伤(AKI),患者可能需要截肢、筋膜切开术和透析。支持性治疗对这些患者的预后具有重要作用。

研究目的

本研究旨在调查 2023 年 2 月 6 日土耳其卡赫拉曼马拉什地震后,靠近震区但未受地震影响的一家医院急诊科收治的创伤性地震幸存者的人口统计学和临床特征。

材料和方法

本研究通过回顾性分析 2023 年 2 月 6 日至 2023 年 2 月 20 日期间,收治于一家三级护理大学医院急诊科的 1110 名创伤性地震幸存者的数据进行。评估年龄、性别、就诊时间、合并症存在情况、急诊科分诊类别、在废墟下停留时间、是否存在其他创伤、实验室检查、AKI 存在情况、挤压伤存在情况和损伤部位、支持性治疗(液体替代和静脉内[IV]碳酸氢钠)、截肢、透析和筋膜切开术需求、住院时间和急诊科结局。

结果

在本研究的 1110 名创伤受害者中,55.5%为女性患者。患者的平均年龄为 45.94(SD=16.7)岁;最小年龄为 18 岁,最大年龄为 95 岁。18.8%的患者存在挤压伤,3.0%的患者存在 AKI。1.6%、2.8%和 1.4%的患者分别需要透析、截肢和筋膜切开术。共有 29.2%的患者住院,包括 2.9%收入重症监护病房(ICU)和 26.3%收入相关病房。共有 0.3%的研究纳入患者在急诊科死亡。

结论

地震后患者可能出现挤压伤,可能发生 AKI,可能需要筋膜切开术、截肢和透析,因此医院和急诊科应做好应对地震等自然灾害的准备。

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