挤压综合征的死亡因素

Engin Onan, Dilek Torun, Rüya Kozanoğlu, Hasan Miçözkadıoğlu, Salih Beyaz, Levent Özgözen, Necmettin Turgut, Yusuf Ziya Demiroğlu, Özlem Karagün, Pınar Ergenoğlu, Özlem Özkan Kuşçu, Ege Altan, Alper Tuna Güven, Alim Abdullayev, İsmail Karluka, Çiğdem Yalçın, Mustafa Mazıcan, İsa Göktürk Balcı, Burak Özkan, Gönül Parmaksız, Begüm Avcı, Aytül Noyan, Turan Çolak, Hüseyin Ali Tünel, Abdulkerim Temiz, Hasan Özkan Gezer, Cankat Erdoğan, Galib Bairamoi, Dilek Yünlüel, Soner Çivi, Emre Durdağ, Özgür Kardeş, Halil İbrahim Süner, Kadir Tufan, Serkan Erkan, Tevfik Avcı, Ramazan Gündoğdu, Murat Kuş, Alper Fındıkçıoğlu, Oya Yıldız, Eda Alışkan, Cenk Coşkunoğlu, Mehmet Haberal
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引用次数: 0

摘要

背景:挤压综合征是大规模灾难性地震后发病和死亡的主要原因。由于没有关于挤压综合征的随机对照研究,因此这方面的知识仅限于专家的经验。本研究的主要目的是分析 2023 年 2 月 6 日帕扎尔奇克和埃尔比斯坦地震后地震受害者的流行病学和人口统计学特征、临床结果和死亡因素:这项横断面观察性回顾研究评估了 2023 年 2 月 6 日至 4 月 30 日期间在本中心就诊的 610 名地震灾民。其中,128 名患者患有挤压综合征。患者信息来自住院期间的医院记录和转诊时的国家登记。主要研究结果是确定死亡率的风险因素。按急性肾损伤(AKI)分期对人口统计学和实验室数据进行了分析;通过回归分析确定了影响死亡率的因素:在128名挤压综合征患者(100名成人,28名儿童)中,64名为女性。AKI 发生率为 32.8%。在出现 AKI 的患者中,需要进行血液透析的比例为 69%,死亡率为 14.2%。挤压综合征患者的总死亡率为 4.6%,而无挤压综合征的地震灾民的总死亡率为 3.9%(19/482)(P=0.705)。值得注意的是,入院时收缩压偏低是唯一显著影响挤压综合征患者死亡率的因素(危险比 [HR]:1.088,P=0.021,95% 置信区间 [CI]):我们的研究表明,入院时收缩压偏低是导致挤压综合征患者死亡率上升的重要风险因素。这一发现强调了在碎石下监测血压和对收缩压过低的患者进行更积极的输液治疗的重要性,从而为相关文献做出了贡献。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mortality Factors in Crush Syndrome.

Background: Crush Syndrome is a major cause of morbidity and mortality following large-scale catastrophic earthquakes. Since there are no randomized controlled studies on Crush Syndrome, knowledge on this subject is limited to expert experience. The primary objective is to analyze the epidemiological and demographic characteristics, clinical outcomes, and mortality factors of earthquake victims after the Pazarcik and Elbistan earthquakes on February 6, 2023.

Methods: This cross-sectional and observational retrospective study evaluated 610 earthquake victims who presented to our center between February 6 and April 30, 2023. Among these patients, 128 with Crush Syndrome were included in the study. Patient information was gathered from hospital records during their stay and from national registries upon referral. The primary outcome was to identify risk factors for mortality. Demographic and laboratory data were analyzed by acute kidney injury (AKI) stages; mortality-affecting factors were identified through regression analysis.

Results: Of the 128 Crush Syndrome patients (100 adults, 28 children), 64 were female. The AKI rate was 32.8%. Among patients with AKI, the frequency of hemodialysis requirement was 69%, and the mortality rate was 14.2%. The overall mortality rate for patients with Crush Syndrome was 4.6%, compared to 3.9% (19/482) in earthquake victims without Crush Syndrome (p=0.705). Notably, low systolic blood pressure at admission was the only factor significantly affecting mortality in Crush Syndrome patients (Hazard Ratio [HR]: 1.088, p=0.021, 95% Confidence Interval [CI]).

Conclusion: Our study highlights low systolic blood pressure upon admission as a significant risk factor for increased mortality in Crush Syndrome patients. This finding may contribute to the literature by emphasizing the importance of monitoring blood pressure under rubble and administering more aggressive fluid therapy to patients with low systolic blood pressure.

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