Simplified and Preliminary Assessment for Dialysis Requirement in Earthquake Patients

Abstract

To the Editor, The article by Yılmaz, et al is very enlightening. 1 The study used entrapment duration, pH levels, creatinine levels, lactate dehydrogenase (LDH) levels, and aspartate transaminase-toalanine transaminase (AST-to-ALT) ratio as key predictors of dialysis requirements in identifying high-risk patients with acute kidney injury (AKI) who require dialysis.Of the predictors in the study, except for the entrapment duration, acquiring these data at disaster sites is challenging and requires assessment at a medical facility. However, prehospital preliminary assessments are important to enable more targeted referrals for patients requiring dialysis. 2 To identify simple indicators readily accessible at disaster sites and potentially meaningful for assessing dialysis requirements, we conducted a retrospective study of earthquake casualty data from a tertiary hospital in an earthquake-stricken area. We collected patients' gender, age, entrapment duration, CRAMS score (circulation, respiration, abdomen, motor, and speech), multiple injuries, and AKI. With Statistical Product and Service Solutions (SPSS) version 26.0.0.0 (IBM Corporation; Armonk, New York USA), logical regression was used for analysis, and P <.05 was considered statistically significant.In total, 263 trauma patients who admitted to the hospital after earthquake were extracted from the hospital system, and two cases of patients lacking relevant data were excluded. Finally, 261 cases were included in the study. Of the enrolled patients, the number of males were 145 (55.6%), females were 116 (44.4%), with an average age of 43.5 (SD = 22.7) years. The median entrapment duration (25% quartile,75% quartile) was 24 (12, 93) and the median CRAMS score (25% quartile,75% quartile) was 10 (9, 10). A total of 158 cases (60.5%) were complicated with multiple injuries, and 25 cases (9.6%) required dialysis for AKI. Logical regression analysis showed that compression time and CRAMS score had statistical significance (P < .05; Table 1).As stated in the original, we agree quite well that entrapment duration, pH levels, creatinine levels, LDH levels, and AST-to-ALT ratio are indicators of dialysis needs. Multiple studies