ICJEM
Intercontinental Journal of Emergency Medicine

The Intercontinental Journal of Emergency Medicine aims to publish issues related to all fields of emergency medicine and all specialties involved in the management of emergencies in the hospital and prehospital environment of the highest scientific and clinical value at an international level and accepts articles on these topics.

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Original Article
The importance of inflammatory indices in the early diagnosis and prognostic evaluation of crush syndrome patients
Abstract
Aims: The increasing frequency of natural disasters has led to a higher incidence of crush injuries. Consequently, with the advancement of disaster medicine in recent years, the number of crush syndrome cases has also risen. In the management of disaster medicine, there is a growing need for rapid and reliable biomarkers for the diagnosis and prognostic evaluation of such cases. Creatine kinase (CK) and C-reactive protein (CRP) are among the most commonly used biomarkers for assessing inflammatory processes. Recently, novel inflammatory indices such as the Systemic Inflammatory Response Index (SIRI), Systemic Immune-Inflammation Index (SII), and Pan-Immune Inflammation Value (PIV) have been shown to play a significant role in the rapid diagnostic and prognostic evaluation of various diseases. This study aimed to determine the diagnostic value and clinical significance of the SII, SIRI, and PIV indices in the diagnosis of crush syndrome.
Methods: This retrospective observational study was conducted on patients diagnosed with crush syndrome who were affected by the earthquake that occurred in Hatay on February 6, 2023, and presented to Ankara Etlik City Hospital between January 1 and December 31, 2023. The included patients were analyzed in terms of laboratory parameters and inflammatory indices and were compared with a control group.
Results: In the patient group, markers of inflammation, tissue damage, and metabolic disruption were found to be significantly elevated compared to the control group. Notably, levels of CRP, WBC, neutrophils, CK, AST, ALT, BUN, and potassium were markedly increased, while calcium and pH levels were decreased. Systemic inflammatory indices such as SII, SIRI, PIV, and NLR were also found to be higher in the patient group. In logistic regression analysis, only the SIRI variable was found to be a statistically significant independent predictor. ROC analyses demonstrated that parameters such as AST, ALT, and SIRI had high diagnostic power. These findings indicate a more pronounced systemic inflammatory and pathophysiological process in the patient group.
Conclusion: The data obtained suggest that inflammatory indices play a critical role in the diagnosis of crush syndrome. In particular, the Systemic Inflammatory Response Index (SIRI) may offer stronger diagnostic value compared to other indices. Therefore, the use of SIRI as a biomarker in the early diagnosis and management of crush syndrome may be beneficial in clinical practice.

Keywords : Crush syndrome, early diagnosis, inflammation, creatine kinase, biomarker, earthquake

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Article available in :
Volume 3, Issue 4, 2025
Page : 73-79
https://doi.org/10.51271/ICJEM-0064
Article Information
Received : 17 Kas 2025
Accepted : 20 Ara 2025
Published : 26 Ara 2025
Corresponding Author :

Ali Kablan: Department of Emergency Medicine, Ankara Etlik City Hospital, Ankara, Turkiye

[email protected]
Citation : Kablan A, Sarcan E, Avcıoğlu G, Kablan S. The importance of inflammatory indices in the early diagnosis and prognostic evaluation of patients with crush syndrome. Intercont J Emerg Med. 2025;3(4):73-79.

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