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Analysis of 372 Patients with Crush Syndrome Caused by the Hanshin-Awaji Earthquake

Oda, Jun MD; Tanaka, Hiroshi MD; Yoshioka, Toshiharu MD; Iwai, Atsushi MD; Yamamura, Hitoshi MD; Ishikawa, Kazuo MD; Matsuoka, Tetsuya MD; Kuwagata, Yasuyuki MD; Hiraide, Atsushi MD; Shimazu, Takeshi MD; Sugimoto, Hisashi MD

The Journal of Trauma: Injury, Infection, and Critical Care: March 1997 - Volume 42 - Issue 3 - p 470-476

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 microL.

Conclusions  Peak serum concentration of creatine kinase as well as the number of injured extremities serve to estimate the severity of crush syndrome.

From the Department of Traumatology and Emergency Medicine, Osaka University Medical School, Osaka, Japan.

This study was supported by a grant from the Ministry of Health and Welfare.

Presented at the 56th Annual Meeting of the American Association for the Surgery of Trauma, September 19-21, 1996, Houston, Texas.

Address for reprints: Jun Oda, MD, Department of Traumatology, Osaka University Medical School, 2-15, Yamadaoka, Suita-shi, Osaka, 565, Japan.

© Williams & Wilkins 1997. All Rights Reserved.