Analysis of 372 patients with Crush syndrome caused by the Hanshin-Awaji earthquake.
OBJECTIVE
To clarify clinical features and determine the severity of injuries in patients with crush syndrome in Hanshin-Awaji earthquake.


METHODS
We retrospectively reviewed medical records of 6,107 patients hospitalized in 95 hospitals, and identified 372 patients with crush syndrome.


RESULTS
The major sites of crush injury were in the lower extremities (74%), followed by the upper extremities (10%), and the trunk (9%). Pelvic fractures, limb fractures, and abdominal injuries were the most frequently associated injury. Patients with trunk compression and/or with abdominal injury had a higher mortality rate. A total of 50 patients (13.4%) died. The causes of death within 5 days after the earthquake were hypovolemia and hyperkalemia. Peak serum creatine kinase concentration increased with the number of crushed extremities. Mortality and the risk of acute renal failure were higher in patients with creatine kinase concentration more than 75,000 micro/L.


CONCLUSIONS
Peak serum concentration of creatine kinase as well as the number of injured extremities serve to estimate the severity of crush syndrome.
Oda
J
J
Department of Traumatology and Emergency Medicine, Osaka University Medical School, Japan.
Tanaka
H
H
Yoshioka
T
T
Iwai
A
A
Yamamura
H
H
Ishikawa
K
K
Matsuoka
T
T
Kuwagata
Y
Y
Hiraide
A
A
Shimazu
T
T
Sugimoto
H
H
D000007:Abdominal Injuries / Q000453:epidemiology; D058186:Acute Kidney Injury / Q000150:complications / Q000401:mortality; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003402:Creatine Kinase / Q000097:blood; D003444:Crush Syndrome / Q000097:blood / Q000453:epidemiology* / Q000401:mortality; D004190:Disasters; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000453:epidemiology; D012189:Retrospective Studies; D013898:Thoracic Injuries / Q000453:epidemiology
D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D003402:Creatine Kinase