Prognostic factors of crush syndrome and survival in elderly earthquake survivors: a retrospective study after the 2023 Turkey disaster

The 2023 Kahramanmaraş earthquake in southern Turkey exposed critical knowledge gaps in trauma complications among geriatric populations. Limited data exist on injury patterns, systemic sequelae, and outcomes in elderly earthquake survivors, particularly those developing crush syndrome. This study analyzes clinical profiles, complications, and mortality risks in elderly patients (≥65 years), comparing those with and without crush syndrome to identify age-specific vulnerabilities. This study was conducted as a single-center retrospective study. 138 patients aged 65 and over who were hospitalized with earthquake-related injuries between February and March 2023 were analyzed, and patients with and without earthquake-related crush syndrome were compared. Demographic, clinical, and laboratory data were used. Of the 138 patients included in the study, 63.8% (n=88) were female, and the mean age was 73.3±7.7 years. 42% (n: 58) of the patients developed crush syndrome. A total of 44.2% underwent surgery, 42.0% developed crush syndrome, 73.9% were discharged, and 8.7% died. In those with crush syndrome, calcium (p=0.03), platelet (p=0.02), lymphocyte (p=0.05) levels were lower; lactate dehydrogenase (p<0.01), creatinine kinase (p<0.01), white blood cell (p<0.01), neutrophil (p<0.01), monocyte (p=0.05) levels were higher and found to be statistically significant. In addition, crush syndrome was seen more in those with upper extremity fractures (p=0.01) and acute renal failure (p=0.02), hemodialysis (p=0.01), fasciotomy (p=0.01), and amputation (p<0.01) were more common in those with crush syndrome. The study highlights significant differences in clinical and laboratory parameters among elderly earthquake survivors with crush syndrome, including higher rates of acute renal failure, hemodialysis, and surgical interventions. These findings underscore the critical need for early recognition and targeted management of crush syndrome in geriatric populations during disaster responses.