A needful, unique, and in-place evaluation of the injuries in earthquake victims with computed tomography, in catastrophic disasters! The 2023 Turkey-Syria earthquakes: part I.

OBJECTIVE: This study was carried out to evaluate the injuries in pediatric earthquake victims due to the 2023 Turkey-Syria earthquakes with computed tomography and determine the anatomotopographic distribution of injuries. METHODS: The material of this retrospective study consisted of the computed tomography findings of 257 pediatric cases injured in the 2023 Turkey-Syria earthquakes, and those were divided into subgroups based on their age group, i.e., 0-4, 5-9, 10-14, and 15-18 years, and the type of injury, i.e., head, maxillofacial, thoracic, abdominal, pelvic, and spinal injuries. RESULTS: Earthquake-related injuries had been detected in 102 (39.6%) patients. Of the 29 patients with multiple injuries, 17, 10, and 2 had injuries in two, three, and four topographic regions, respectively. The most common injury was a head injury, which was detected in 48 (18.7%) cases, followed by thoracic injury, spinal injury, pelvic fracture, abdominal injury, and maxillofacial fracture, which were detected in 40 (15.6%), 22 (8.5%), 19 (7.4%), 10 (3.9%), and 6 (2.3%) patients, respectively. The cranial bone fractures and intracranial injuries were significantly more frequent in the 0-4 years age group compared with other age groups (p=0.028 and p=0.024, respectively). The rib fractures with spinal and pleural injuries were significantly more common in the 15-18 years age group compared with others (p=0.016, p=0.004, and p=0.002, respectively). CONCLUSION: The head injury was the most common earthquake-related injury in pediatric cases. Herein, it was more common in younger children compared with other age groups, whereas rib, spine, and pleural injuries were more common in older children.

Lactate measurements accurately predicts 1-week mortality in emergency department patients with acute kidney injury.

BACKGROUND: Studies on prognostic indicators in patients with acute kidney injury are limited. This study investigated 1-week mortality, laboratory and clinical parameters according to the lactate levels in patients with acute kidney injury. METHODS: In this cross-sectional study, we compared the lactate levels on admission and follow-up in emergency department with vital findings, laboratory parameters, and 1-week mortality. RESULTS: Data of 3375 patients examined; 2681 patients excluded and 694 patients were included. Median lactate level on admission was 1.6 (1.1-2.5) mmol/L for patients who discharged from emergency department, 2.2 (1.3-3.4) mmol/L for patients admitted to the hospital wards, 3.7 (1.7-7.2) mmol/L for patients admitted to the intensive care unit and 4.4 (2.4-8.0) mmol/L for patients with mortality within 1-week of ED presentation. Mortality was 30.4% in patients with high lactate levels and 8.1% in patients with normal lactate levels on admission. (p < 0.001, odds ratio 5.0, 95% CI 3.2-7.7) Elevated lactate level was independent risk factor for 1-week-mortality. (p < 0.001, odds ratio 1.138, 95% CI 1.067-1.214) Patients with high lactate levels have low systolic blood pressure, diastolic blood pressure, oxygen saturation, pH, base deficit, and bicarbonate, and higher heart rate and respiratory rate. The mortality of patients with normal lactate levels on admission was 8.1%, while mortality rate increased to 19% if elevated lactate levels observed during emergency department follow-up. CONCLUSIONS: Elevated lactate level predicts 1-week mortality in patients presenting with acute kidney injury in emergency department. Elevated lactate level were associated with poorer vital signs and abnormal laboratory results.

A needful, unique, and in-place evaluation of the injuries in earthquake victims with computed tomography, in catastrophic disasters! The 2023 Turkey-Syria earthquakes: part I

SUMMARY OBJECTIVE: This study was carried out to evaluate the injuries in pediatric earthquake victims due to the 2023 Turkey-Syria earthquakes with computed tomography and determine the anatomotopographic distribution of injuries. METHODS: The material of this retrospective study consisted of the computed tomography findings of 257 pediatric cases injured in the 2023 Turkey-Syria earthquakes, and those were divided into subgroups based on their age group, i.e., 0-4, 5-9, 10-14, and 15-18 years, and the type of injury, i.e., head, maxillofacial, thoracic, abdominal, pelvic, and spinal injuries. RESULTS: Earthquake-related injuries had been detected in 102 (39.6%) patients. Of the 29 patients with multiple injuries, 17, 10, and 2 had injuries in two, three, and four topographic regions, respectively. The most common injury was a head injury, which was detected in 48 (18.7%) cases, followed by thoracic injury, spinal injury, pelvic fracture, abdominal injury, and maxillofacial fracture, which were detected in 40 (15.6%), 22 (8.5%), 19 (7.4%), 10 (3.9%), and 6 (2.3%) patients, respectively. The cranial bone fractures and intracranial injuries were significantly more frequent in the 0-4 years age group compared with other age groups (p=0.028 and p=0.024, respectively). The rib fractures with spinal and pleural injuries were significantly more common in the 15-18 years age group compared with others (p=0.016, p=0.004, and p=0.002, respectively). CONCLUSION: The head injury was the most common earthquake-related injury in pediatric cases. Herein, it was more common in younger children compared with other age groups, whereas rib, spine, and pleural injuries were more common in older children.