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Trends of Serum Electrolyte Changes in Crush syndrome patients of Bam Earthquake; a Cross sectional Study

Saeed Safari, Mehdi Eshaghzade, Iraj Najafi, Alireza Baratloo, Behrooz Hashemi, Mohammad Mehdi Forouzanfar, Farhad Rahmati
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Abstract

Introduction: Electrolyte imbalances are very common among crushed earthquake victims but there is not
enough data regarding their trend of changes. The present study was designed to evaluate the trend of changes
in sodium, calcium, and phosphorus ions among crush syndrome patients. Methods: In this retrospective
cross-sectional study, using the database of Bam earthquake victims, which was developed by Iranian Society of
Nephrology following Bam earthquake, Iran, 2003, the 10-day trend of sodium, calcium, and phosphorus ions
changes in > 15 years old crush syndrome patients was evaluated. Results: 118 patients with the mean age of
25.6 § 6.9 yearswere studied (57.3 male). On the first day of admission, 52.5% (95% CI: 42.7 - 62.3) of the patients
had hyponatremia, which reached 43.9% (95% CI: 28.5 - 59.3) on day 10. 100.0% of patients were hypocalcemic
on admission and serum calcium level did not change dramatically during the 10 days of hospitalization. The
prevalence of hyperphosphatemia on the first day was 90.5% (95% CI: 81.5 - 99.5) and on the 10th day of hospitalization
66.7% (95% CI: 48.5 - 84.8) of the patients were still affected. Conclusion: The results of the present
study shows the 52.5%prevalence of hyponatremia, 100% hypocalcemia, and 90.5% hyperphosphatemia among
crush syndrome patients of Bam earthquake victims on the first day of admission. Evaluation of 10-day trend
shows a slow decreasing pattern of these imbalances as after 10 days, 43.9% still remain hyponatremic, 92.3%
hypocalcemic, and 66.7% hypophosphatemic.

Keywords

Earthquakes; crush syndrome; water-electrolyte imbalance; rhabdomyolysis; disaster victims

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DOI: http://dx.doi.org/10.22037/emergency.v5i1.11910

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