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Objectives: Dysnatremia is a critical electrolyte disturbance that can significantly impact the prognosis of trauma patients by influencing fluid balance, neurological function, and hemodynamics. Although sodium disorder is common in hospitalized patients, few studies have specifically examined the incidence of dysnatremia in patients presenting to the emergency department for post-earthquake trauma. The aim of this study is to evaluate the incidence of dysnatremia and the prognosis of patients with dysnatremia in trauma patients admitted to our center after the Kahramanmaraş earthquake. Materials and methods: Between February 6th, 2023 and February 20th, 2023, a total of 422 patients with earthquake-related crush injuries after the Kahramanmaras earthquake were retrospectively analyzed. Patients were divided into two groups: the survivor group and the exitus group. Then, patients with dysnatremia were evaluated. Age, gender, the city where patients came from, type of presentation, injured organ systems and extremities, laboratory findings, ward admission, intensive care admission, GCS, MESS, ISS, RTS, TRISS, and hemodialysis sessions were analyzed. Results: A total of 422 earthquake victims with crush injuries were included in the study. Dysnatremia was present in 28% of the patients, and these patients had a longer hospital stay. GCS was lower, MESS and ISS values were higher, and survival rates according to TRISS were lower. Multiple extremity trauma, crush syndrome, and dialysis rates were more common in the dysnatremia group. Additionally, fasciotomy, amputation and mortality rates were higher in the dysnatremia group. Conclusion: Dysnatremia is a common finding in patients with crush injuries and is associated with more severe trauma and poorer clinical outcomes. This study highlights the need for close monitoring and management of sodium disturbances in trauma patients, not only in the context of earthquakes but across various disaster scenarios. Recognizing and addressing dysnatremia can contribute to improved patient outcomes in disaster and emergency settings. [ABSTRACT FROM AUTHOR]

Purpose: Crush injuries result from the physical compression of muscles and may lead to crush syndrome. Early fluid resuscitation and surgical intervention is key. Few studies have reported the outcomes of crush injuries in the non-disaster setting. This retrospective study aims to characterise such cases. Methods: Patients with lower limb crush injuries were identified from an internal database. Non-crush injuries and patients under the age of 18 were excluded. Types of injuries, management, and complications were extracted. Results: 27 patients were included. The right leg (n = 10) was the most frequently injured site. Mechanisms included being run over by vehicles (n = 10) and being crushed by, between, or inside vehicles (n = 8). Fractures were the most common acute injuries (n = 16), while other injuries included rhabdomyolysis, compartment syndrome and degloving. Fluid resuscitation was required in 17 patients. 58 surgeries were performed on 18 patients, with wound debridement and amputations being common. Complications such as acute kidney injury, hyperkalaemia, and sepsis were noted during hospitalisation. Individuals with injuries to the leg or thigh experienced a greater burden of injury and incidence of in-hospital complications compared to those with isolated injuries to the foot. Conclusion: Crush injuries in the non-disaster setting show distinct mechanisms and injury patterns. Those with crush injuries to the leg or thigh more closely resemble a patient cohort seen in the disaster setting compared to those with isolated foot injuries. [ABSTRACT FROM AUTHOR]

Aim: This study aims to examine earthquake-related upper extremity orthopedic injuries, and in our clinic, the plastic, reconstructive, and esthetic treatment methods applied to them after the two biggest earthquakes in Kahramanmaraş, Turkey. Materials and Methods: This is a descriptive cross-sectional study and was conducted with 38 earthquake victims who were treated at the plastic, reconstructive, and esthetic surgery unit of a medical school health and research hospital in the Southeast Anatolia region of Turkey. Patient data were obtained retrospectively from electronic medical records, and descriptive statistical methods, Chi-square test, and post hoc were used for data analysis. Results: Of the earthquake victims, 55% were between 18 and 35 years old, 68% were female, 63% underwent plastic, reconstructive, and esthetic surgery due to upper extremity injuries, 50% had skin grafting, and 15% had amputation. In addition, 18.4% of the earthquake victims underwent surgery 3 times, and 13% were operated on 7 times. Conclusion: Careful attention should be paid to the treatment of upper extremity injuries that occur during major earthquakes. Delayed or inadequate interventions can result in amputation, highlighting the importance of plastic, reconstructive, and esthetic surgeons in disaster response teams. If possible, conservative treatment should be preferred for fractures in disaster environments. Amputation should always be the last treatment option for crush injuries. In cases requiring surgery, time should not be wasted. [ABSTRACT FROM AUTHOR]

It is important to predict which patients may require renal replacement therapy (RRT) at the time of initial presentation after crush injuries. There is limited data in the literature examining the predictors of RRT. This study was conducted by evaluating 2232 patients who presented to our hospital following two major earthquakes of magnitudes 7.6 and 7.7 Mw that occurred in Kahramanmaras, Turkey, on February 6, 2023. A total of 314 patients who were hospitalized upon being rescued from the rubble and had a creatine kinase (CK) level above 1000 U/L were included in the final analysis. Factors predicting the need for RRT were investigated, and a dialysis score was developed for this prediction. Of the 314 patients included in the study, 95 (30.2 %) developed acute kidney injury (AKI). RRT was performed on 68 (21.6 %) patients. The optimal cut-off value of CK for the prediction of AKI was 23,000 U/L. Multivariate analysis revealed that factors predicting RRT were the number of traumatized sides (odds ratio [OR]: 2.2, 95 % confidence interval [CI]: 1.09–4.39, p = 0.026), albumin (OR:0.11, 95 % CI: 0.04–0.32, p < 0.001), and CK (OR: 1.00, 95 % CI 1.00–1.00, p < 0.001). A dialysis score was developed ranging from 0 to 7 based on the number of traumatized sides, albumin, and CK. The area under the curve (AUC) of the dialysis score in receiver operating characteristic analysis was 0.974. A dialysis score of 4 or higher had a sensitivity of 97.1 % and a specificity of 89.4 % for predicting the need for RRT. The dialysis score predicts the need for RRT quite well. The simplicity of use and high sensitivity and specificity of this score in earthquake-related crush injuries will greatly facilitate clinicians in patient triage and follow-up. [ABSTRACT FROM AUTHOR]