Department of Orthopaedics and Traumatology, Elazığ Fethi Sekin City Hospital, Elazığ 23050, Turkey.
Medicina (Kaunas). 2023 Sep 3;59(9):1593. doi: 10.3390/medicina59091593.
: The current study aims to determine the impact of fasciotomy on mortality and morbidity in children and adults with crush-related AKI following the 2023 Kahramanmaraş earthquakes. : The study included individuals who had suffered crush injuries after the 2023 Kahramanmaraş earthquakes and were identified as having an acute kidney injury (AKI). Patients with an AKI were divided into two groups based on age: those under 18 years and those over 18 years. A comparative analysis was conducted between the mortality and morbidity rates of patients who underwent fasciotomy and those who did not. Disseminated intravascular coagulopathy (DIC), sepsis, and adult respiratory distress syndrome (ARDS) have all been identified as contributors to morbidity. : The study was conducted with a total of 40 patients (21 males and 19 females) aged between 4 and 83 years. A total of 21 patients underwent fasciotomy, and the patients underwent varying numbers of fasciotomy, ranging from 0 to 11. The mortality rate was 12.5%, corresponding to five adult patients. No instances of mortality were reported in the paediatric cohort. The application of fasciotomy in instances of crush-induced AKI did not result in elevated levels of mortality in either the paediatric or adult demographic. Within the adult population, a substantial difference in the duration of dialysis was observed between individuals who underwent fasciotomy and those who did not. A statistically significant increase in the number of fasciotomy incisions was observed in patients diagnosed with sepsis compared with those without sepsis. The study found a significant positive correlation between the number of fasciotomy incisions and dialysis days. : Neither adult nor paediatric patients with crush-induced AKI showed an increased risk of death after fasciotomy. The number of fasciotomy incisions significantly correlated with the development of sepsis. Despite experiencing delays in hospital admission for paediatric patients, the incidence of both crush syndrome and mortality rates among children remained relatively low.
:本研究旨在探讨筋膜切开术对 2023 年土耳其卡赫拉曼马拉什地震后挤压相关急性肾损伤(AKI)的儿童和成人死亡率和发病率的影响。:该研究纳入了在 2023 年土耳其卡赫拉曼马拉什地震中遭受挤压伤并被诊断为急性肾损伤(AKI)的患者。将 AKI 患者按年龄分为两组:18 岁以下和 18 岁以上。对接受筋膜切开术和未接受筋膜切开术的患者的死亡率和发病率进行了比较分析。弥散性血管内凝血(DIC)、脓毒症和成人呼吸窘迫综合征(ARDS)均被认为是发病率的原因。:该研究共纳入 40 例患者(21 名男性和 19 名女性),年龄在 4 至 83 岁之间。共有 21 例患者接受了筋膜切开术,接受筋膜切开术的患者数量从 0 到 11 不等。死亡率为 12.5%,对应 5 名成年患者。儿科患者未报告死亡。在挤压伤引起的 AKI 病例中应用筋膜切开术并没有导致儿科或成年人群的死亡率升高。在成年人群中,接受筋膜切开术和未接受筋膜切开术的患者在透析持续时间方面存在显著差异。与无脓毒症的患者相比,诊断为脓毒症的患者的筋膜切开切口数量明显增加。研究发现筋膜切开切口数量与透析天数之间存在显著正相关。:挤压伤引起的 AKI 无论是在儿童还是成人患者中,筋膜切开术后死亡风险均未增加。筋膜切开切口数量与脓毒症的发生显著相关。尽管儿科患者住院时间延迟,但儿童挤压综合征和死亡率的发生率仍然相对较低。