Author/Authors :
Hosseini, Mostafa Department of Epidemiology and Biostatistics - School of Public Health - Tehran University of Medical Sciences , Safari, Saeed Department of Nephrology - Shariati Hospital - Tehran University of Medical Sciences - Department of Emergency medicine - Imam Hossein Hospital - Shahid Beheshti University of Medical Sciences, Tehran , Sharifi, Ali Department of Nephrology - Shariati Hospital - Tehran University of Medical Sciences , Amini, Manuchehr Department of Nephrology - Shariati Hospital - Tehran University of Medical Sciences , Rashid Farokhi, Farin Department of Nephrology - Kerman University of Medical Sciences , Sanadgol, Houshang Department of Nephrology - Zahedan University of Medical Sciences , Seirafian, Shiva Department of Nephrology - Isfahan University of Medical Sciences , Mooraki, Ahmad Department of Nephrology - Rasool Akram Hospital - Iran University of Medical Sciences, Tehran , Samimagham, Hamidreza Department of Nephrology - Bandarabbas University of Medical Sciences, Bandarabbas , Pourfarziani, Vahid Department of Nephrology - Milad hospital, Tehran , Atabak, Shahnaz Department of Nephrology - Imam Hossein Hospital - Shahid Beheshti University of Medical Sciences, Tehran , Osareh, Shahrzad Department of Nephrology - Hasheminejad Hospital - Iran University of Medical Sciences, Tehran , Boroumand, Behrouz Department of Nephrology - Rasool Akram Hospital - Iran University of Medical Sciences, Tehran , Najafi, Iraj Urology Research Center, Tehran - Department of Nephrology - Shariati Hospital - Tehran University of Medical Sciences
Abstract :
In the natural disasters such as earthquake, based on severity of trauma, time under the rubble and
quality/quantity of hydratation we will confront with a spectrum of traumatic rhabdomyolysis. In present
study we evaluate victims of Bam earthquake to show different stage of muscle trauma, from minor trauma
with almost normal level of muscle enzyme to those with moderate trauma leading to crush injury and finally
to advanced crush syndrome. Questionnaire consisted of clinical, biochemical and demographic items was
designed and completed by our research team retrospectively. We divided the patients to crush and non-crush
and also crush injury and crush syndrome, and then compared aforementioned items between them. Clinical
and laboratory data of 2962 hospitalized victims, with an average age of 28.4(SD14.2) years (range 1-90)
were collected (40% female). 611 patients were affected with crush injury (20%). These were entrapped 2.2
hours longer than the others (P<0.001). Mean IV intake in first 5 days was 3.6(SD2.6) liters for these patients
in compare with 2.5(SD1.4) liters for others (P<0.001). 200 cases showed complete feature of crush syndrome.
Electrolyte imbalance and systemic complications were drastically increased in the worst patients
with crush syndrome. In approach to crushed patients of natural disasters by attention to the wide spectrum of
muscle damage and systemic problems, the stepwise management protocol based on severity of traumatic
rhabdomyolysis is inevitable and warranted.
