Trends of Serum Electrolyte Changes in Crush syndrome patients of Bam Earthquake; a Cross sectional Study
Archives of Academic Emergency Medicine,
Vol. 5 No. 1 (2017),
1 January 2017
,
Page e7
https://doi.org/10.22037/aaem.v5i1.110
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 years were 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.
- Earthquakes
- crush syndrome
- water-electrolyte imbalance
- rhabdomyolysis
- disaster victims
How to Cite
References
Tan C, Lee V, Chang G, Ang H, Seet B. Medical response to the 2009 Sumatra earthquake: health needs in the post-disaster period. Singapore medical journal. 2012;53(2):99-103.
Chou Y-J, Huang N, Lee C-H, Tsai S-L, Chen L-S, Chang H-J. Who is at risk of death in an earthquake? American Journal of Epidemiology. 2004;160(7):688-95.
Erek E, Sever MS, Serdengecti K, Vanholder R, Akoglu E, Yavuz M, et al. An overview of morbidity and mortality in patients with acute renal failure due to crush syndrome: the Marmara earthquake experience. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. 2002;17(1):33-40.
Najafi I, Hosseini M, Safari S, Shojaee A, Sharifi A, Mehrani M, et al. Treatment outcomes of compartment syndrome in bam earthquake victims. Iranian Journal of Epidemiology. 2010;5(4):26-30.
Epstein FH, Odeh M. The role of reperfusion-induced injury in the pathogenesis of the crush syndrome. New England Journal of Medicine. 1991;324(20):1417-22.
Criddle LM. Rhabdomyolysis Pathophysiology, Recognition, and Management. Critical Care Nurse. 2003;23(6):14-30.
Safari S, Najafi I, Hosseini M. Outcomes of fasciotomy in patients with crush-induced acute kidney injury after Bam earthquake. Iranian journal of kidney diseases. 2011;5(1):25.
Sever MS, Vanholder R, Lameire N. Management of crush-related injuries after disasters. New England Journal of Medicine. 2006;354(10):1052-63.
Zhang L, Fu P, Wang L, Cai G, Zhang L, Chen D, et al. Hyponatraemia in patients with crush syndrome during the Wenchuan earthquake. Emergency medicine journal : EMJ. 2013;30(9):745-8.
Waikar SS, Mount DB, Curhan GC. Mortality after hospitalization with mild, moderate, and severe hyponatremia. The American journal of medicine. 2009;122(9):857-65.
Oda Y, Shindoh M, Yukioka H, Nishi S, Fujimori M, Asada A. Crush syndrome sustained in the 1995 Kobe, Japan, earthquake; treatment and outcome. Annals of emergency medicine. 1997;30(4):507-12.
Alavi-Moghaddam M, Safari S, Najafi I, Hosseini M. Accuracy of urine dipstick in the detection of patients at risk for crush-induced rhabdomyolysis and acute kidney injury. European Journal of Emergency Medicine. 2012;19(5):329-32.
Iraj N, Saeed S, Mostafa H, Houshang S, Ali S, Farin RF, et al. Prophylactic fluid therapy in crushed victims of Bam earthquake. The American journal of emergency medicine. 2011;29(7):738-42.
Najafi I, Safari S, Sharifi A, Sanadgol H, Hosseini M, Rashid-Farokhi F, et al. Practical strategies to reduce morbidity and mortality of natural catastrophes: a retrospective study based on Bam earthquake experience. Archives of Iranian medicine. 2009;12(4):347-52.
Rajagopalan S. Crush injuries and the crush syndrome. Medical Journal Armed Forces India. 2010;66(4):317-20.
Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. Harrison's Principles of Internal Medicine 19/E (Vol. 1 & Vol. 2): McGraw Hill Professional; 2015.
Adams D, de Jonge R, van der Cammen T, Zietse R, Hoorn EJ. Acute kidney injury in patients presenting with hyponatremia. Journal of nephrology. 2011;24(6):749-55.
Donmez O, Meral A, Yavuz M, Durmaz O. Crush syndrome of children in the Marmara Earthquake, Turkey. Pediatrics international : official journal of the Japan Pediatric Society. 2001;43(6):678-82.
Efstratiadis G, Voulgaridou A, Nikiforou D, Kyventidis A, Kourkouni E, Vergoulas G. Rhabdomyolysis updated. Hippokratia. 2007;11(3):129-37.
Yokota J. Crush syndrome in disaster. Japan Medical Association Journal. 2005;48(7):341-52.
Malinoski DJ, Slater MS, Mullins RJ. Crush injury and rhabdomyolysis. Critical care clinics. 2004;20(1):171-92.
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