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Background <p>Crush syndrome is a potentially life-threatening complication of prolonged compression injuries, frequently encountered after earthquakes. The 2023 Kahramanmaraş earthquakes in Türkiye caused extensive crush-related trauma. The objective of this study was to assess the effect of baseline crush syndrome severity on hospitalization outcomes and complications.</p> Methods <p>In this multicenter, retrospective observational study, 962 crush syndrome patients hospitalized after the earthquakes were evaluated. Patients were grouped as mild-moderate vs. severe-critical based on clinical presentation. Demographics, laboratory results, comorbidities, trauma types, complications, and outcomes were assessed. Comparisons between groups were performed using the Mann–Whitney U test and chi-square test, and survival analysis was conducted with the Kaplan–Meier method.</p> Results <p>Of 962 patients, 232 (24.1%) were classified as severe-critical and 730 (75.9%) as mild-moderate. “Severe-critical patients had significantly higher rates of hypotension (38.8% vs 2.3%), ARDS (10.2% vs 1.7%), sepsis (31.7% vs 9.1%), DIC (8.5% vs 1.4%), arrhythmias (11.9% vs 0.8%), compartment syndrome (53.5% vs 36.9%), and ICU (95.6% vs 40.9%) requirement than mild-moderate (all p&lt;0.001)”. Laboratory markers including BUN, creatinine, potassium, phosphorus, liver enzymes, CK, and CRP were all significantly elevated, while calcium and albumin levels were lower in the severe-critical group (p&lt;0.05). Kaplan–Meier analysis revealed a significantly lower survival rate in the severe-critical group (67.7% vs. 97.7%, p&lt;0.001). Trauma types such as cranial, abdominal, and thoracic injuries were more frequent in this group, and prolonged entrapment time [median 18 (8-40) vs. 10 (6-33) hours, p&lt;0.05] was correlated with increased severity.</p> Conclusions <p>Crush syndrome severity at admission is strongly correlated with clinical outcomes, complication rates, and in-hospital survival. Prolonged time under the rubble, systemic complications, and elevated muscle and renal injury markers contribute to worse prognosis. These findings highlight the need for rapid triage, timely fluid resuscitation, and organized multidisciplinary intervention in future disaster scenarios.</p>

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Impact of crush syndrome severity on clinical outcomes after the earthquakes in southeastern Türkiye

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月4日

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  • Kenan Turgutalp,
  • Savas Ozturk,
  • Neriman Sila Koc,
  • Murside Esra Dolarslan,
  • Ismail Kocyigit,
  • Didem Turgut,
  • Tuncay Sahutoglu,
  • Dilek Torun,
  • Ozlem Usalan,
  • Orcun Altunoren,
  • Ramazan Danis,
  • Gursel Yildiz,
  • Ali Gurel,
  • Mehmet Horoz,
  • Mehmet Kucuksu,
  • Suleyman Karakose,
  • Mehmet Riza Altiparmak,
  • Mehmet Deniz Ayli,
  • Murat Tugcu,
  • Zehra Eren,
  • Tolga Yildirim,
  • Fatma Betul Guzel,
  • Nedim Yilmaz Selcuk,
  • Esra Akcali,
  • Dede Sit,
  • Mehmet Polat,
  • Saliha Yildirim,
  • Selma Alagoz,
  • Sibel Bek,
  • Irem Pembegul,
  • Tahsin Karaaslan,
  • Funda Sari,
  • Ayça Inci,
  • Numan Gorgulu,
  • Mahmut Gok,
  • Zeki Aydin,
  • Kubra Bahat,
  • Yavuz Ayar,
  • Serap Demir,
  • Zeynep Ebru Eser,
  • Murat Hayri Sipahioglu,
  • Bahar Gurlek Demirci,
  • Meliha Ozkutlu,
  • Engin Onan,
  • Ahmet Alper Kiykim,
  • Ayse Serra Artan,
  • Emrah Erkan Mazi,
  • Nergiz Bayrakci,
  • Murathan Uyar,
  • Kubra Kaynar,
  • Ayhan Dogukan,
  • Sena Ulu,
  • Serhan Tuglular

摘要

Background

Crush syndrome is a potentially life-threatening complication of prolonged compression injuries, frequently encountered after earthquakes. The 2023 Kahramanmaraş earthquakes in Türkiye caused extensive crush-related trauma. The objective of this study was to assess the effect of baseline crush syndrome severity on hospitalization outcomes and complications.

Methods

In this multicenter, retrospective observational study, 962 crush syndrome patients hospitalized after the earthquakes were evaluated. Patients were grouped as mild-moderate vs. severe-critical based on clinical presentation. Demographics, laboratory results, comorbidities, trauma types, complications, and outcomes were assessed. Comparisons between groups were performed using the Mann–Whitney U test and chi-square test, and survival analysis was conducted with the Kaplan–Meier method.

Results

Of 962 patients, 232 (24.1%) were classified as severe-critical and 730 (75.9%) as mild-moderate. “Severe-critical patients had significantly higher rates of hypotension (38.8% vs 2.3%), ARDS (10.2% vs 1.7%), sepsis (31.7% vs 9.1%), DIC (8.5% vs 1.4%), arrhythmias (11.9% vs 0.8%), compartment syndrome (53.5% vs 36.9%), and ICU (95.6% vs 40.9%) requirement than mild-moderate (all p<0.001)”. Laboratory markers including BUN, creatinine, potassium, phosphorus, liver enzymes, CK, and CRP were all significantly elevated, while calcium and albumin levels were lower in the severe-critical group (p<0.05). Kaplan–Meier analysis revealed a significantly lower survival rate in the severe-critical group (67.7% vs. 97.7%, p<0.001). Trauma types such as cranial, abdominal, and thoracic injuries were more frequent in this group, and prolonged entrapment time [median 18 (8-40) vs. 10 (6-33) hours, p<0.05] was correlated with increased severity.

Conclusions

Crush syndrome severity at admission is strongly correlated with clinical outcomes, complication rates, and in-hospital survival. Prolonged time under the rubble, systemic complications, and elevated muscle and renal injury markers contribute to worse prognosis. These findings highlight the need for rapid triage, timely fluid resuscitation, and organized multidisciplinary intervention in future disaster scenarios.