A retrospective review of patients admitted to a tertiary intensive care unit following the February 6th earthquake in Türkiye

BACKGROUND: The Kahramanmaraþ earthquake that occurred in Türkiye in 2023 affected 14 million people, resulting in 53,537 deaths and more than 100,000 injuries. In large-scale disasters, it is crucial to rapidly initiate complex treatment processes in hospitals equipped with tertiary intensive care units following the initial on-site response. In this study, we aimed to retrospectively analyze the types of trauma and the associated surgical and medical treatments of patients affected by the earthquake who were admitted to our level 3 intensive care unit. Our objective was to contribute to future disaster preparedness planning in healthcare institutions and to improve intensive care treatment strategies.
METHODS: This retrospective single-center study was conducted at Mersin City Training and Research Hospital. Clinical data of patients treated in the tertiary intensive care unit were reviewed. The recorded variables included demographic characteristics, time of hospital admission, length of hospital stay, complete blood count, creatine kinase, myoglobin, albumin levels, liver and renal func-tion tests, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, type of trauma, presence of crush syndrome and acute kidney injury, surgical interventions and types of surgery, renal replacement therapy, blood transfusion, fluid therapy, nutritional support, requirement for mechanical ventilation, psychiatric support, hyperbaric oxygen therapy, mortality, and referral to another hospital.
RESULTS: A total of 80 patients were included in the study; 53.8% were female, and the mean age was 49.93 years. The overall mortality rate was 22.5%. The mean age was higher in the mortality group, and lymphocyte count was also significantly higher in this group. The proportion of patients receiving renal replacement therapy was greater in the mortality group compared to survivors (p=0.035). Eleven patients died within the first five days of admission, and 13 of the deceased patients had acute kidney injury. Mechanical ventilation and total parenteral nutrition were more frequently required in the mortality group.
CONCLUSION: Advanced age, the need for total parenteral nutrition, renal replacement therapy, and mechanical ventilation were identified as predictors of mortality among trauma patients followed in a tertiary intensive care unit.

Keywords: earthquake, intensive care, mortality, renal replacement treatment

Türkiye'de 6 Þubat depreminde üçüncü basamak yoðun bakým ünitesinde tedavi edilen hastalarýn retrospektif olarak incelenmesi

AMAÇ: Türkiye'de 2023 yýlýnda meydana gelen Kahramanmaraþ depremi 14 milyon insaný etkilemiþtir. Deprem 53.537 kiþinin ölümüne ve 100.000'den fazla yaralýnýn geride kalmasýna neden olmuþtur. Bu tür büyük afetlerde, sahada ilk müdahaleyi takiben geliþmiþ yoðun bakým ünitesine sahip hastanelerde komplike tedavi süreçlerinin hýzla baþlatýlmasý çok önemlidir. Bu çalýþmada, depremden etkilenen ve 3. seviye yoðun bakým ünitemize kabul edilen hastalarýn travma türlerini, iliþkili cerrahi ve týbbi tedavilerini retrospektif olarak analiz etmeyi planladýk. Sonuç olarak, saðlýk kurumlarýnda doðal afetlere yönelik hazýrlýklar ve yoðun bakým ünitesindeki tedavi stratejileri hakkýnda ileriye dönük yapýlacak planlamalara ilham olmayý amaçladýk
GEREÇ VE YÖNTEM: Bu retrospektif tek merkezli çalýþma, Mersin Þehir Eðitim ve Araþtýrma Hastanesi'nin üçüncü basamak yoðun bakým ünitesin-de tedavi gören hastalarýn klinik bilgilerinin toplandýðý bir çalýþmadýr. Hastalarýn demografik verileri, hastaneye geliþ zamaný, hastanede kalýþ süresi, tam kan sayýmý, kreatin kinaz, miyoglobin, albümin düzeyleri, karaciðer ve böbrek fonksiyon testleri, APACHE II skoru, travma tipi, ezilme sendro-mu, akut böbrek hasarý varlýðý, cerrahi giriþim, cerrahi tipleri, renal replasman tedavisi, kan transfüzyonu, sývý tedavisi, beslenme desteði, mekanik ventilasyon ihtiyacý, psikiyatrik destek, hiperbarik oksijen tedavisi, mortalite, baþka bir hastaneye sevk edilme durumlarý kaydedildi.
BULGULAR: Bu çalýþmaya %53.8'i kadýn olan ve yaþ ortalamasý 49.93 olan 80 hasta dahil edilmiþtir. Mortalite oraný %22.5 olup ortalama yaþ daha yüksektir, ayný þekilde lenfosit sayýsý da anlamlý derecede yüksek bulunmuþtur. Mortalite grubunda renal replasman tedavisi alan hasta yüzdesi sað kalan gruba göre daha yüksekti. (p=0.035) Ölen hastalarýn 13'ünde akut böbrek hasarý mevcuttu ve 11 hasta ilk beþ gün içinde öldü. Mekanik ven-tilasyon ve total parenteral beslenme uygulanan hastalar ölüm grubunda daha yaygýndý.
SONUÇ: Üçüncü basamak yoðun bakým ünitesinde takip edilen travma hastalarýnda ileri yaþ, total parenteral beslenme, renal replasman tedavisi ve mekanik ventilasyon varlýðý mortalite için prediktör olarak bulunmuþtur.

Anahtar Kelimeler: deprem, yoðun bakým, mortalite, renal replasman tedavisi