Document Detail


Clinical features and outcome of crush syndrome caused by the Chi-Chi earthquake.
MedLine Citation:
PMID:  12101860     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Few reports exist concerning the peak serum concentration of creatine kinase (CK) and the severity of crush syndrome, and the efficacy of fasciotomy in crush syndrome patients remains controversial. This study aimed to analyze and assess the clinical features, treatment, and outcome of patients with crush syndrome sustained in the Chi-Chi earthquake in September 21, 1999. METHODS: Pertinent data were collected from major hospitals in central Taiwan via questionnaire. Patients with a peak serum CK concentration of more than 1,000 U/L within 2 weeks following the earthquake were included in the study. Eight hospitals responded and a total of 95 patients were included for the analysis. RESULTS: Forty-four patients (46.3%) with acute renal failure were found to have a serum creatinine level of more than 159 mumol/L (1.8 mg/dL) or daily urine output of less than 400 mL. Thirty patients (31.6%) required hemodialysis, which completely restored renal function. The incidence of acute oliguria, acute renal failure, and the need for hemodialysis were significantly increased if the peak CK concentration was more than 50,000 U/L (p < 0.01). Thirty-five patients underwent fasciotomy to treat compartment syndrome caused by crush syndrome. Among these, 31 patients (88.6%) had a peak CK concentration higher than 10,000 U/L. The incidence of acute renal failure (p < 0.01) and the need for hemodialysis (p < 0.01) were significantly higher in the fasciotomy group than in the non-fasciotomy group. Eight patients developed superficial infection and 16 developed deep infections after fasciotomy. Six patients underwent amputations and one patient died of sepsis due to uncontrolled infection of the fasciotomy wound. CONCLUSION: CK concentration is a good indicator of the occurrence of acute renal failure and the need for dialysis. The high infection rate and amputation rate after fasciotomy may be due to inadequate debridement. Fasciotomy in crush syndrome patients with high serum CK concentrations should be deliberated.
Authors:
Kui-Chou Huang; Tu-Sheng Lee; Yu-Min Lin; Kuo-Hsiung Shu
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the Formosan Medical Association = Taiwan yi zhi     Volume:  101     ISSN:  0929-6646     ISO Abbreviation:  J. Formos. Med. Assoc.     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-07-09     Completed Date:  2002-07-18     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9214933     Medline TA:  J Formos Med Assoc     Country:  China (Republic: 1949- )    
Other Details:
Languages:  eng     Pagination:  249-56     Citation Subset:  IM    
Affiliation:
Department of Orthopedics and Traumatology, Taichung Veterans General Hospital, 160, Section 3, Chung-Kang Road, Taichung, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Child
Child, Preschool
Creatine Kinase / blood
Crush Syndrome / complications*,  therapy
Disasters*
Fascia / surgery
Female
Humans
Infant
Kidney Failure, Acute / etiology
Male
Middle Aged
Renal Dialysis
Taiwan
Chemical
Reg. No./Substance:
EC 2.7.3.2/Creatine Kinase

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