ArticleUlusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES2026
Anesthetic management and early outcomes in patients with earthquake-induced crush and compartment syndrome: A single-center retrospective an.
Article in Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThis retrospective study aimed to evaluate anesthesia management, intraoperative support strategies, and 60-day clinical outcomes in patients requiring surgical intervention, including fasciotomy and/or amputation, due to crush and compartment syndrome following the February 6, 2023, Kahramanmaraş earthquakes. The study also sought to identify predictors of mortality and contribute to the field of disaster medicine.
methodsThis single-center study reviewed the data of 64 patients who underwent emergency surgery between February 6 and April 6, 2023. Retrospectively collected and analyzed data included patient demographics, ASA (American Society of Anesthesiologists) physical status classification, anesthesia techniques used, intraoperative support provided, and 60-day follow-up clinical outcomes, including mortality, renal function, and muscle necrosis markers.
resultsMost patients (93.8%) underwent surgery under general anesthesia due to systemic instability. This finding highlights the critical role of the systemic effects of traumatic injuries and crush syndrome in the choice of anesthesia. The 60-day mortality rate was 11.1%. Significant decreases in muscle necrosis markers, such as CK, AST, and ALT, were observed after fasciotomy. This finding suggests that even delayed fasciotomy may be effective in reducing the systemic toxic load. A key finding was that the preoperative albumin/lactate ratio was identified as a strong and independent predictor of mortality. This ratio may serve as a practical biomarker for patient risk stratification and prognosis.
conclusionIn cases of crush and compartment syndrome following an earthquake, general anesthesia was widely preferred over regional techniques because of patients' severe systemic instability. The data show that surgical interventions, such as fasciotomy, can successfully reduce the systemic toxic load and improve patient outcomes. Furthermore, a simple biomarker, such as the preoperative albumin/lactate ratio, could be a critical tool for predicting patient risk and mortality, especially in resource-limited settings following a disaster. This study provides important information for planning anesthesia and surgical management strategies in similar disaster situations.
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