Epidemiologic aspects of the Bam earthquake in Iran: the nephrologic perspective.
BACKGROUND
Acute renal failure is a serious, preventable, and potentially reversible midterm complication after mass disasters. In 2003, an earthquake struck Bam, Iran. This article studies the epidemiologic aspects of the earthquake from a nephrologic perspective.


METHODS
A questionnaire was sent to the reference hospitals. The resulting database of 2,086 traumatized patients hospitalized in the first 10 days was analyzed.


RESULTS
Mean age was 29.0 +/- 15.6 years. Compared with the resident population, the percentage of patients was lower among children and teenagers younger than 15 years and higher among young and middle-aged adults (P < 0.001). There was no significant difference between mean ages of patients with acute renal failure and other patients. Time under the rubble was longer for patients with acute renal failure (6.2 +/- 4.1 versus 2.1 +/- 3.9 hours; P < 0.001). These patients were hospitalized later (3.1 +/- 2.8 versus 1.5 +/- 1.7 days after the disaster; P < 0.001) and longer (16.7 +/- 12.8 versus 12.5 +/- 11.3 days; P < 0.001). Sepsis (11.6% versus 0.5%), disseminated intravascular coagulation (7.3% versus 0.3%), adult respiratory distress syndrome (9.1% versus 1.4%), fasciotomy (38.9% versus 1.9%), amputation (6.1% versus 0.5%), and death (12.7% versus 1.9%) were markedly more frequent among patients with acute renal failure (P < 0.001 for all).


CONCLUSIONS
Hospitalized patients were mostly young and middle-aged adults. Patients with acute renal failure were entrapped longer and hospitalized later and for longer periods. Medical complications, surgical procedures, and mortality were greater in the latter group. Early extrication and quick hospitalization with appropriate multidisciplinary care are cornerstones to prevent acute renal failure and its subsequent mortality in earthquake conditions.
Nephrology Research Center, Dr Shariati Hospital, Tehran, Iran. hatamizadehp@hotmail.com
Parta
P
Hatamizadeh
Iraj
I
Najafi
Raymond
R
Vanholder
Farin
F
Rashid-Farokhi
Hooshang
H
Sanadgol
Shiva
S
Seyrafian
Ahmad
A
Mooraki
Shahnaz
S
Atabak
Hamidreza
H
Samimagham
Vahid
V
Pourfarziani
Behrooz
B
Broumand
Wim
W
Van Biesen
Norbert
N
Lameire
D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004190:Disasters; D005260:Female; D006801:Humans; D007223:Infant; D007492:Iran; D008297:Male; D008875:Middle Aged; D014947:Wounds and Injuries / Q000150:complications / Q000453:epidemiology