Kahramanmaraş Merkezli Depremlerde Yoğun Bakım Ünitesine Kabul Edilen Hastaların Retrospektif Değerlendirilmesi: Tek Merkez Analizi
Öz
6 Şubat 2023'te Türkiye'yi vuran iki büyük yıkıcı deprem 11 ili etkiledi. Kahramanmaraş ili merkez üssüydü. Bu çalışmanın amacı bu depremlerden sonra yoğun bakım ünitesine (YBÜ) yatırılan depremzedelerin tıbbi analizlerini ve hayatta kalma durumlarını araştırmaktı. Ayrıca depremde yatan hastaların ölümüyle ilgili faktörler de araştırıldı. Bu retrospektif, kesitsel, tek merkezli çalışma, 6 Şubat 2023 ile 21 Şubat 2023 tarihleri arasında yoğun bakım ünitesine yatırılan depremzedeler üzerinde gerçekleştirildi. Tüm hastaların demografik özellikleri, Akut Fizyoloji ve Kronik Sağlık Değerlendirmesi II (Apache II) skorları, Glasgow Koma Skalası (GKS) değerleri, laboratuvar parametreleri, kurum içi ve dışı sevk durumları, sağ kalım durumları, yoğun bakımda kalış süreleri, hemodiyaliz gereksinimleri gibi verileri kaydedildi.45 depremzede (20 kadın ve 25 erkek) yaş ortalaması 38,9 ± 18,7 yıl idi. Yoğun bakıma kabulde 25 hasta entübe idi. Toplam 19 hastaya hemodiyaliz uygulandı, 20 hasta öldü, 9 hasta hastane içine sevk edildi, 16 hasta hastane dışına sevk edildi. Çalışmada, kabulde daha yüksek entübasyon oranlarının, daha yüksek serum kreatinin, prokalsitonin, laktat ve Apache II değerlerinin, daha düşük Ph, nötrofil/lenfosit oranı (NLR) ve GKS değerlerinin ölüm riskini artırdığı gözlendi. Depremler yaşamı tehdit eden doğal afetlerdir. Deprem mağdurlarının klinik ve laboratuvar parametrelerinin tanımlanması, hayatta kalma durumunun tahmininde çok önemlidir.
Anahtar Kelimeler
Kaynakça
- 1. The Turkish Ministry of Interior Disaster and Emergency Management Presidency . Preliminary assessment report on the 6 February 2023 Pazarcık (Kahramanmaraş) MW 7.7, Elbistan (Kahramanmaraş) MW 7.6 earthquakes. Earthquake Department.2023. Available from: https://deprem.afad.gov.tr. Accessed October 6, 2023.
- 2. Demirkiran O, Dikmen Y, Utku T, Urkmez S. Crush syndrome patients after the Marmara earthquake. Emerg Med J. 2003;20(3):247-250.
- 3. Moro M, Cannelli V, Chini M, et al. The October 23, 2011, Van (Turkey) earthquake and its relationship with neighbouring structures. Sci Rep. 2014;4:3959.
- 4. Altunel E, Kozacı Ö, Yıldırım C, Sbeinati RM, Meghraoui M. Potential domino effect of the 2023 Kahramanmaraş earthquake on the centuries-long seismic quiescence of the Dead Sea fault: inferences from the North Anatolian fault. Sci Rep. 2024;14(1):15440.
- 5. Aydin K, Yesilyurt AO, Cetinkaya F, et al. Earthquake victims in focus: a cross-sectional examination of trauma and management in intensive care unit. BMC Emerg Med. 2024; 24(1):30.
- 6. Hu H, Lai X, Tan C, Yao N, Yan L. Factors associated with in-patient mortality in the rapid assessment of adult earthquake trauma patients. Prehosp Disaster Med. 2022;37(3):299–305.
- 7. Hidalgo J, Baez AA. Natural disasters. Crit Care Clin. 2019;35(4): 591–607.
- 8. NOAA National Centers for Environmental Information (NCEI). 2023. Available from: https://www.ngdc.noaa.gov/hazel/view/hazards/earthquake/event-more-info/10662. Accessed October 8, 2023
- 9. Disel NR, Taskin O, Daglioglu G, et al. Factors affecting the mortality of February eathquakes victims of Türkiye. Am J Emerg Med. 2024;77:115-120.
- 10. Qi J, Bao L, Yang P, Chen D. Comparison of base excess, lactate and Ph predicting 72-h mortality of multiple trauma. BMC Emerg Med. 2021; 21(1):80.
- 11. Pan ST, Cheng YY, Lin CH. Extrication time and earthquake related- mortality in the 2016 Taiwan earthquake. J Formos Med Assoc. 2019;118(11):1504-1514.
- 12. Hu H, Yao N, Lai XQ. Factors related to early and rapid assessment of in-hospital mortality among older adult trauma patients in an earthquake. World J Emerg Med. 2022;13(6):425-432.
- 13. Godinjak A, Iglica A, Rama A, et al. Predictive value of SAPS II and APACHE II scoring systems for patient outcome in a medical intensive care unit. Acta Med Acad. 2016;45(2):97-103.
- 14. Dilektasli E, Inaba K, Haltmeier T, et al. The prognostic value of neutrophil to lymphocyte ratio on mortality in critically ill trauma patients. J Trauma Acute Care Surg. 2016;81(5):882-888.
- 15. Erek E, Sever MS, Serdengeçti K, et al. An overview of morbidity and mortality in patients with acute renal failure due to crush syndrome: the Marmara earthquake experience. Nephrol Dial Transplant. 2022;17(1): 33-40.
- 16. Wang R, Hua Y, He M, Xu J. Prognostic value of serum procalcitonin based model in moderate to severe traumatic brain injury patients. J Inflamm Res. 2022;15:4981–4993.
- 17. Mann EA, Wood GL, Wade CE. Use of procalcitonin for the detection of sepsis in the critically ill burn patient: a systematic review of the literature. Burns. 2011;37(4):549–558.
- 18. Colak M, Kilinc MA, Güven R, Kutlu NO. Procalcitonin and blood lactate level as predictive biomarkers in pediatric multiple trauma patients’ pediatric intensive care outcomes: A retrospective observational study. Medicine. 2023;102(49):e36289.
Retrospective Evaluation of Patients Admitted to Intensive Care Unit in Kahramanmaraş Centered Earthquakes in Türkiye: A Single Center Analysis
Öz
On February 6, 2023, two major devastating earthquakes hit Turkey, impacting 11 provinces. Kahramanmaraş province was the epicenter. The aim of this study was to investigate the medical analysis and survival status of earthquake victims admitted to the intensive care unit (ICU) after these earthquakes. Factors associated with mortality among hospitalized earthquake victims were also explored. This retrospective, cross-sectional, single-center study was conducted on earthquake victims who were admitted to the ICU between February 6, 2023, and February 21, 2023. Data including demographic characteristics, Acute Physiology and Chronic Health Evaluation II (Apache II) scores, Glasgow Coma Scale (GCS) values, laboratory parameters, in- or out-of-institution referral status, survival status, length of stay in the ICU, and hemodialysis requirements of all the patients were recorded. Of the 45 earthquake victims (20 females and 25 males), the mean age was 38.9 ± 18.7 years. 25 patients were intubated at the time of admission to the ICU. A total of 19 patients required hemodialysis, 20 patients died, 9 patients were referred inside the hospital, 16 were referred outside the hospital. It was observed in the study that higher rates of intubation on admission, higher serum creatinine, procalcitonin, lactate and Apache II values, lower Ph, neutrophil/ lymphocyte ratio (NLR) and GCS values showed an increased risk of death. Earthquakes are life- threatening natural disasters. The definition of the clinical and laboratory parameters of the earthquake victims is crucial on the prediction of survival status.
Anahtar Kelimeler
Death earthquake intensive care unit, trauma earthquake victim
Etik Beyan
Yapılan çalışmada, araştırma ve yayın etiğine uyulmuştur.
Kaynakça
- 1. The Turkish Ministry of Interior Disaster and Emergency Management Presidency . Preliminary assessment report on the 6 February 2023 Pazarcık (Kahramanmaraş) MW 7.7, Elbistan (Kahramanmaraş) MW 7.6 earthquakes. Earthquake Department.2023. Available from: https://deprem.afad.gov.tr. Accessed October 6, 2023.
- 2. Demirkiran O, Dikmen Y, Utku T, Urkmez S. Crush syndrome patients after the Marmara earthquake. Emerg Med J. 2003;20(3):247-250.
- 3. Moro M, Cannelli V, Chini M, et al. The October 23, 2011, Van (Turkey) earthquake and its relationship with neighbouring structures. Sci Rep. 2014;4:3959.
- 4. Altunel E, Kozacı Ö, Yıldırım C, Sbeinati RM, Meghraoui M. Potential domino effect of the 2023 Kahramanmaraş earthquake on the centuries-long seismic quiescence of the Dead Sea fault: inferences from the North Anatolian fault. Sci Rep. 2024;14(1):15440.
- 5. Aydin K, Yesilyurt AO, Cetinkaya F, et al. Earthquake victims in focus: a cross-sectional examination of trauma and management in intensive care unit. BMC Emerg Med. 2024; 24(1):30.
- 6. Hu H, Lai X, Tan C, Yao N, Yan L. Factors associated with in-patient mortality in the rapid assessment of adult earthquake trauma patients. Prehosp Disaster Med. 2022;37(3):299–305.
- 7. Hidalgo J, Baez AA. Natural disasters. Crit Care Clin. 2019;35(4): 591–607.
- 8. NOAA National Centers for Environmental Information (NCEI). 2023. Available from: https://www.ngdc.noaa.gov/hazel/view/hazards/earthquake/event-more-info/10662. Accessed October 8, 2023
- 9. Disel NR, Taskin O, Daglioglu G, et al. Factors affecting the mortality of February eathquakes victims of Türkiye. Am J Emerg Med. 2024;77:115-120.
- 10. Qi J, Bao L, Yang P, Chen D. Comparison of base excess, lactate and Ph predicting 72-h mortality of multiple trauma. BMC Emerg Med. 2021; 21(1):80.
- 11. Pan ST, Cheng YY, Lin CH. Extrication time and earthquake related- mortality in the 2016 Taiwan earthquake. J Formos Med Assoc. 2019;118(11):1504-1514.
- 12. Hu H, Yao N, Lai XQ. Factors related to early and rapid assessment of in-hospital mortality among older adult trauma patients in an earthquake. World J Emerg Med. 2022;13(6):425-432.
- 13. Godinjak A, Iglica A, Rama A, et al. Predictive value of SAPS II and APACHE II scoring systems for patient outcome in a medical intensive care unit. Acta Med Acad. 2016;45(2):97-103.
- 14. Dilektasli E, Inaba K, Haltmeier T, et al. The prognostic value of neutrophil to lymphocyte ratio on mortality in critically ill trauma patients. J Trauma Acute Care Surg. 2016;81(5):882-888.
- 15. Erek E, Sever MS, Serdengeçti K, et al. An overview of morbidity and mortality in patients with acute renal failure due to crush syndrome: the Marmara earthquake experience. Nephrol Dial Transplant. 2022;17(1): 33-40.
- 16. Wang R, Hua Y, He M, Xu J. Prognostic value of serum procalcitonin based model in moderate to severe traumatic brain injury patients. J Inflamm Res. 2022;15:4981–4993.
- 17. Mann EA, Wood GL, Wade CE. Use of procalcitonin for the detection of sepsis in the critically ill burn patient: a systematic review of the literature. Burns. 2011;37(4):549–558.
- 18. Colak M, Kilinc MA, Güven R, Kutlu NO. Procalcitonin and blood lactate level as predictive biomarkers in pediatric multiple trauma patients’ pediatric intensive care outcomes: A retrospective observational study. Medicine. 2023;102(49):e36289.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Anesteziyoloji |
| Bölüm | ORİJİNAL MAKALELER / ORIGINAL ARTICLES |
| Yazarlar | |
| Yayımlanma Tarihi | 2 Mayıs 2025 |
| Gönderilme Tarihi | 7 Şubat 2025 |
| Kabul Tarihi | 24 Mart 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 47 Sayı: 3 |