Crush Syndrome: Biological Profile of Patients Victims of the Al Haouz Earthquake - About 100 Cases

Crush syndrome encompasses local and systemic manifestations secondary to prolonged ischemia of significant muscle masses, resulting from intense and sustained compression [1]. This massive rhabdomyolysis poses a life-threatening prognosis due to the onset of either hypovolemia with shock, sudden hyperkalemia, or acute renal failure. Following the earthquake that struck Al Haouz on September 8, 2023, in El Haouz, 71.8 km southwest of Marrakech, with a magnitude of 6.9, a prospective study was conducted on 100 patients admitted to the emergency department of the Avicenne Military Hospital in Marrakech. These patients presented various traumas and muscle compressions, with varying severity levels and locations. Upon admission, levels of myoglobinemia, creatine phosphokinase, creatinine, and kalemia were measured. Hyperkalemia was detected in 4 individuals with concentrations exceeding 5.5 mmol/L. Analysis of creatine phosphokinase (CPK) revealed that 27% of the patients suffered from rhabdomyolysis, with CPK levels exceeding 1000 IU/L. Among these patients, 5 had severe rhabdomyolysis with CPK levels surpassing 5000 IU/L. 25% of the patients with rhabdomyolysis developed acute renal failure, a complication also present in all cases of severe rhabdomyolysis. In terms of myoglobinemia, 16% of the patients had levels exceeding 500 µg/L, and 11 patients had levels above 1000 µg/L. Notably, all patients with severe rhabdomyolysis exhibited myoglobinemia levels exceeding 1000 µg/L, correlating with the development of acute renal failure.