Authors: Mustafa Comoglu, Fatih Acehan, Osman Inan, Burak Furkan Demir, Yusufcan Yılmaz, Enes Seyda Sahiner
Journal: American Journal of Emergency Medicine, 2024 October 18
Conclusions:
The dialysis score accurately predicts the need for RRT in patients with earthquake-related crush injuries. Its simplicity and high predictive accuracy make it a valuable tool for triage and management in mass casualty settings, allowing for more efficient and effective patient care.
Methods:
This study analyzed 2232 patients admitted after two major earthquakes (magnitudes 7.6 and 7.7 Mw) that struck Kahramanmaras, Turkey, on February 6, 2023. The analysis included 314 patients hospitalized with creatine kinase (CK) levels exceeding 1000 U/L. The study investigated predictors of RRT and developed a scoring system (dialysis score) based on these findings.
Results:
Out of 314 patients, 95 (30.2%) developed acute kidney injury (AKI), and 68 (21.6%) required RRT. The optimal CK cut-off for predicting AKI was 23,000 U/L. Multivariate analysis identified the number of traumatized sides (odds ratio [OR]: 2.2), albumin level (OR: 0.11), and CK (OR: 1.00) as significant predictors of RRT. A dialysis score ranging from 0 to 7 was developed based on these factors. The dialysis score demonstrated an area under the curve (AUC) of 0.974. A score of 4 or higher predicted the need for RRT with a sensitivity of 97.1% and specificity of 89.4%.