Wide Spectrum of Traumatic Rhabdomyolysis in Earthquake Victims

Abstract

In the natural disasters such as earthquake, based on severity of trauma, time under the rubble and quality/quantity of hydratation we will confront with a spectrum of traumatic rhabdomyolysis. In present study we evaluate victims of Bam earthquake to show different stage of muscle trauma, from minor trauma with almost normal level of muscle enzyme to those with moderate trauma leading to crush injury and finally to advanced crush syndrome. Questionnaire consisted of clinical, biochemical and demographic items was designed and completed by our research team retrospectively. We divided the patients to crush and non-crush and also crush injury and crush syndrome, and then compared aforementioned items between them. Clinical and laboratory data of 2962 hospitalized victims, with an average age of 28.4(SD14.2) years (range 1-90) were collected (40% female). 611 patients were affected with crush injury (20%). These were entrapped 2.2 hours longer than the others (P<0.001). Mean IV intake in first 5 days was 3.6(SD2.6) liters for these patients in compare with 2.5(SD1.4) liters for others (P<0.001). 200 cases showed complete feature of crush syndrome. Electrolyte imbalance and systemic complications were drastically increased in the worst patients with crush syndrome. In approach to crushed patients of natural disasters by attention to the wide spectrum of muscle damage and systemic problems, the stepwise management protocol based on severity of traumatic rhabdomyolysis is inevitable and warranted.