ArticleUlusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES2026
Clinical predictors of mortality in earthquake victims with crush-related acute kidney injury requiring hemodialysis.
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
backgroundMajor earthquakes frequently cause crush injuries that lead to acute kidney injury (AKI), posing significant challenges for medical teams. Understanding which patients are at the highest risk of mortality can help physicians make better treatment decisions during these disasters. This study examined earthquake victims who developed severe kidney problems requiring dialysis to identify factors that predict survival.
methodsA retrospective cohort study was conducted at a major tertiary hospital. Of the 5,338 earthquake victims treated, 1,416 adults developed AKI, of whom 159 required hemodialysis for crush-related injuries. Demographics, clinical features, laboratory parameters, and outcomes were analyzed during logistic regression to identify independent predictors of mortality.
resultsThe cohort's mean age was 38.3±14.6 years, with 62.9% male. Mortality was 30.8%. Independent predictors of mortality were septic shock (odds ratio [OR]: 52.148), elevated sodium levels (OR: 1.186), and hypoalbuminemia (OR: 0.877). Prolonged extrication time, systemic infections, and metabolic acidosis were significantly associated with mortality. Demand for hemodialysis peaked in the 1st week, with hyperkalemia and sepsis as major complications.
conclusionMortality among earthquake victims with crush-related renal injury depends primarily on overall disease severity rather than renal function alone. Septic shock, blood chemistry imbalances, and prolonged entrapment were the main determinants of survival. Prompt rescue and aggressive treatment of infections and metabolic problems are essential to saving lives in future disasters.
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