Characteristics and outcomes of critically ill injured patients admitted to intensive care units after the earthquake in Southeast Turkiye: Multicenter retrospective analysis

Two consecutive earthquakes that razed the southeast part of Turkiye on February 06, 2023, were one of the strongest earthquakes ever recorded in the last century. Unfortunately, over 13 million people were affected in 11 provinces, and around 50,000 patients passed away, based on the official reports of the Turkish Government (1). Data from previous earthquakes demonstrated that 80% of patients who suffered from earthquakes stuck under the rubble suddenly died, and 10% survived with minor injuries. The remaining 10% of patients had severe injuries and needed hospitalization, including intensive care unit (ICU) admission (2). Presenting the issues encountered in earthquakes and sharing experiences and the results of the medical interventions can enable more accurate treatments to be applied after future earthquakes. Therefore, this study aims to provide information regarding the characteristics of earthquake-related medical disorders, the applied treatment modalities, and the outcomes in patients admitted to intensive care units who were affected by the earthquakes occurred on February 06, 2023. Patients and methods The data of earthquake victims admitted to 13 ICUs of 9 hospitals in Turkiye between February 6, 2023, and March 6, 2023, were recorded retrospectively. All adult patients with an ICU stay of >24 h were enrolled in the study. Patient demographics, medical history, admission, and 72 h follow-up parameters (complications, respiratory and hemodynamic support, nutrition, sedation) and laboratory findings (biochemistry, hemogram, coagulation parameters, cardiac enzymes) and outcomes were retrospectively recorded from hospitals' printed and electronic health record systems. Results Two hundred two (N = 202) patients with a median age of 35.5 [IQR,26–56] years were included. 56.4% of them were male. The APACHE-2 and admission SOFA scores were 16.8 ± 8.3 and 3.5 [IQR,1–6], respectively. The median time from being stuck under the rubble to rescue was 12 h [IQR,6–31.5]. Crush syndrome was diagnosed in 63.8%, and 60.8% had acute kidney injury at ICU admission. Forty-nine patients (24.2%) received intermittent hemodialysis before ICU admission. During their ICU stay, 33.1% required invasive mechanical ventilation, 20.7% had vasoactive drug support, and 43.5% needed renal replacement therapy. The median ICU length of stay was 5[IQR,2–10] days, with an 11.3% 28-day mortality rate. Conclusion Crush syndrome and acute kidney injury (AKI) are frequent complications of earthquake victims requiring intensive care follow-up. Renal replacement therapy is needed in more than half of AKI patients, which should be considered in future disasters to arrange health resources. References 1. https://en.afad.gov.tr/press-bulletin-36-about-the-earthquake-in-kahramanmaras2. Better OS. The crush syndrome revisited. Nephron. 1990;55(2):97–103. doi:10.1159/000185934. PMID: 2194135.