Bayyigit Akif, Gunay F Hande, Yerli Mustafa, Ervatan Zekeriya, Karmis E Belen, Kadioglu Kocak M Gulay
Department of Internal Medicine, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey.
Department of Orthopedics and Traumatology, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey.
Disaster Med Public Health Prep. 2024 Dec 10;18:e308. doi: 10.1017/dmp.2024.263.
Many people who are rescued alive from rubble after earthquakes suffer from crush injuries and associated acute kidney injury (AKI). McMahon score is used to determine the risk of AKI and mortality due to rhabdomyolysis in hospitalized patients. In this study, we aimed to evaluate the clinical findings, biochemical characteristics, and outcomes of crush injury patients admitted to our tertiary hospital and the use of the McMahon score in determining the need for renal replacement therapy (RRT) in this patient group.
Sociodemographic, clinical, and biochemical parameters of 28 patients who had creatine kinase levels of 1000 U/L and above were recorded. Patients with crush injuries requiring and not requiring RRT were compared according to the McMahon Score.
A total of 42% of patients developed AKI and 67% of them required renal replacement therapy. In crush injury patients requiring RRT, serum urea, creatinine, LDH, aspartate aminotransferase, alanine transaminase, phosphorus, and procalcitonin levels were significantly higher and albumin levels were significantly lower at admission compared to patients not requiring RRT. All patients who required RRT had a McMahon Score ≥6.
A high McMahon score at hospital admission is associated with an increased need for RRT.
许多在地震后从废墟中被成功救出的人会遭受挤压伤及相关的急性肾损伤（AKI）。麦克马洪评分用于确定住院患者因横纹肌溶解导致AKI和死亡的风险。在本研究中，我们旨在评估入住我院三级医院的挤压伤患者的临床症状、生化特征及预后情况，以及麦克马洪评分在确定该患者群体是否需要肾脏替代治疗（RRT）方面的应用。
记录28例肌酸激酶水平在1000 U/L及以上患者的社会人口统计学、临床和生化参数。根据麦克马洪评分对需要和不需要RRT的挤压伤患者进行比较。
共有42%的患者发生AKI，其中67%的患者需要肾脏替代治疗。与不需要RRT的患者相比，需要RRT的挤压伤患者入院时血清尿素、肌酐、乳酸脱氢酶、天冬氨酸转氨酶、丙氨酸转氨酶、磷和降钙素原水平显著升高，白蛋白水平显著降低。所有需要RRT的患者麦克马洪评分均≥6。
入院时麦克马洪评分高与RRT需求增加相关。
