Evaluation of Clinical and Laboratory Findings and Outcomes in Patients Suffering from Earthquake-Related Crush Injury: Who Needs Renal Replacement Therapy?

Abstract

Objectives: 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.

Methods: 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.

Results: 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.

Conclusions: A high McMahon score at hospital admission is associated with an increased need for RRT.