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Impact of local circumstances on outcome of renal casualties in major disasters

ARJAN VAN DER TOL (UGent) , A Hussain, MS Sever, Stefaan Claus (UGent) , Wim Van Biesen (UGent) , Eric Hoste (UGent) , S Khan and Raymond Vanholder (UGent)
(2009) NEPHROLOGY DIALYSIS TRANSPLANTATION. 24(3). p.907-912
Author
Organization
Abstract
Background. In the aftermath of earthquakes, the cumulative incidence of crush-induced acute kidney injury (AKI) is difficult to predict. Insight into factors determining this risk is indispensable to allow adequate logistical planning, which is a prerogative for success in disaster management. Methods. Data of 88 crush-related AKI patients in the aftermath of the Kashmir earthquake were collected and outcome measures were analysed. Then the findings were compared with the data of 596 crush-related AKI patients of the Marmara earthquake. Results. The earthquake in Kashmir occurred in a rural area with lack of medical facilities and difficult transportation conditions while the earthquake in Marmara occurred in an urban area with more efficient transport possibilities. In Kashmir we reported fewer patients with treated AKI (1.2 AKI per 1000 deaths, 1.3 AKI per 1000 victims) than in Marmara (34.1 AKI per 1000 deaths; P < 0.001, 13.6 AKI per 1000 victims; P < 0.001). Time lag between earthquake and admission to hospitals was longer in Kashmir (5.8 +/- 5.8 days) than in Marmara (3.5 +/- 3.7 days; P < 0.001). The frequencies of fasciotomies (P < 0.001), amputations (P < 0.001) and dialysis (P = 0.005) were lower in Kashmir, than in Marmara AKI patients. Conclusions. The cumulative incidence of treated AKI related to number of deaths or victims might differ substantially among earthquakes. Many factors may affect the frequency of AKI: hampered rescue and transport possibilities; destroyed medical facilities on the spot; availability or not of sophisticated therapeutic possibilities and structure of the buildings might all have impacted on different cumulative incidence between Kashmir and Marmara.
Keywords
KASHMIR, IRAN, EARTHQUAKE, FAILURE, VICTIMS, MANAGEMENT, MORTALITY, INJURIES

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MLA
VAN DER TOL, ARJAN, et al. “Impact of Local Circumstances on Outcome of Renal Casualties in Major Disasters.” NEPHROLOGY DIALYSIS TRANSPLANTATION, vol. 24, no. 3, OXFORD UNIV PRESS, GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND, 2009, pp. 907–12, doi:10.1093/ndt/gfn557.
APA
VAN DER TOL, A., Hussain, A., Sever, M., Claus, S., Van Biesen, W., Hoste, E., … Vanholder, R. (2009). Impact of local circumstances on outcome of renal casualties in major disasters. NEPHROLOGY DIALYSIS TRANSPLANTATION, 24(3), 907–912. https://doi.org/10.1093/ndt/gfn557
Chicago author-date
VAN DER TOL, ARJAN, A Hussain, MS Sever, Stefaan Claus, Wim Van Biesen, Eric Hoste, S Khan, and Raymond Vanholder. 2009. “Impact of Local Circumstances on Outcome of Renal Casualties in Major Disasters.” NEPHROLOGY DIALYSIS TRANSPLANTATION 24 (3): 907–12. https://doi.org/10.1093/ndt/gfn557.
Chicago author-date (all authors)
VAN DER TOL, ARJAN, A Hussain, MS Sever, Stefaan Claus, Wim Van Biesen, Eric Hoste, S Khan, and Raymond Vanholder. 2009. “Impact of Local Circumstances on Outcome of Renal Casualties in Major Disasters.” NEPHROLOGY DIALYSIS TRANSPLANTATION 24 (3): 907–912. doi:10.1093/ndt/gfn557.
Vancouver
1.
VAN DER TOL A, Hussain A, Sever M, Claus S, Van Biesen W, Hoste E, et al. Impact of local circumstances on outcome of renal casualties in major disasters. NEPHROLOGY DIALYSIS TRANSPLANTATION. 2009;24(3):907–12.
IEEE
[1]
A. VAN DER TOL et al., “Impact of local circumstances on outcome of renal casualties in major disasters,” NEPHROLOGY DIALYSIS TRANSPLANTATION, vol. 24, no. 3, pp. 907–912, 2009.
@article{519467,
  abstract     = {{Background. In the aftermath of earthquakes, the cumulative incidence of crush-induced acute kidney injury (AKI) is difficult to predict. Insight into factors determining this risk is indispensable to allow adequate logistical planning, which is a prerogative for success in disaster management.
Methods. Data of 88 crush-related AKI patients in the aftermath of the Kashmir earthquake were collected and outcome measures were analysed. Then the findings were compared with the data of 596 crush-related AKI patients of the Marmara earthquake.

Results. The earthquake in Kashmir occurred in a rural area with lack of medical facilities and difficult transportation conditions while the earthquake in Marmara occurred in an urban area with more efficient transport possibilities. In Kashmir we reported fewer patients with treated AKI (1.2 AKI per 1000 deaths, 1.3 AKI per 1000 victims) than in Marmara (34.1 AKI per 1000 deaths; P < 0.001, 13.6 AKI per 1000 victims; P < 0.001). Time lag between earthquake and admission to hospitals was longer in Kashmir (5.8 +/- 5.8 days) than in Marmara (3.5 +/- 3.7 days; P < 0.001). The frequencies of fasciotomies (P < 0.001), amputations (P < 0.001) and dialysis (P = 0.005) were lower in Kashmir, than in Marmara AKI patients.

Conclusions. The cumulative incidence of treated AKI related to number of deaths or victims might differ substantially among earthquakes. Many factors may affect the frequency of AKI: hampered rescue and transport possibilities; destroyed medical facilities on the spot; availability or not of sophisticated therapeutic possibilities and structure of the buildings might all have impacted on different cumulative incidence between Kashmir and Marmara.}},
  author       = {{VAN DER TOL, ARJAN and Hussain, A and Sever, MS and Claus, Stefaan and Van Biesen, Wim and Hoste, Eric and Khan, S and Vanholder, Raymond}},
  issn         = {{0931-0509}},
  journal      = {{NEPHROLOGY DIALYSIS TRANSPLANTATION}},
  keywords     = {{KASHMIR,IRAN,EARTHQUAKE,FAILURE,VICTIMS,MANAGEMENT,MORTALITY,INJURIES}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{907--912}},
  publisher    = {{OXFORD UNIV PRESS, GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND}},
  title        = {{Impact of local circumstances on outcome of renal casualties in major disasters}},
  url          = {{http://doi.org/10.1093/ndt/gfn557}},
  volume       = {{24}},
  year         = {{2009}},
}
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