Aoki et al developed two models for predicting the Crush Syndrome based on data available at triage. The models are based on data from the Kobi earthquake in 1995. The authors are from the University of Texas Houston and multiple institutions in Japan and the United States.
Patient selection: compressed in a collapsed building
Outcomes:
(1) severe crush injury (acute renal failure requiring hemodialysis)
(2) death
Parameters:
(1) rescue time in hours
(2) urine color
(3) pulse rate in beats per minute
(4) white blood cell count per µL
(5) potassium
|
Parameter |
Finding |
Points |
|
rescue time |
< 3 hours |
0 |
|
|
>= 3 hours |
1 |
|
urine color |
normal (clear to yellow) |
0 |
|
|
abnormal (brown to red) |
2.25 |
|
pulse rate |
< 120 beats per minute |
0 |
|
|
>= 120 beats per minute |
2.5 |
|
white blood cell count |
< 18,000 per µL |
0 |
|
|
>= 18,000 per µL |
1.7 |
|
potassium |
< 5 mmol/L |
0 |
|
|
>= 5 mmol/L |
1 |
where:
• The points are the LOG(odds ratio).
sum of log odds ratio for model 1 =
= (points for rescue time) + (points for urine color) + (points for pulse rate)
sum of log odds ratio for model 2 =
= (points for urine color) + (points for pulse rate) + (points for WBC count) + (points for potassium)
|
Sum Model 1 |
Probability of Severe or Fatal Crush Syndrome |
|
0 |
2% |
|
1 |
8% |
|
2.25 |
23% |
|
2.6 |
27% |
|
3.25 |
44% |
|
3.5 |
50% |
|
4.75 |
78% |
|
5.75 |
91% |
|
Sum Model 2 |
Probability of Severe or Fatal Crush Syndrome |
|
0 |
4% |
|
0.92 to 3.12 |
(0.04133 * ((SUM)^2)) + (0.01610 * (SUM)) + 0.04944 |
|
3.12 to 6.08 |
(-0.04079 * ((SUM)^2)) + (0.5276 * (SUM)) - 0.7508 |
|
> 6.08 |
> 95% |
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general
