Evaluating the McMahon score for predicting mortality in earthquake-induced rhabdomyolysis: a retrospective study

Postgrad Med J. 2024 Dec 23;101(1191):45-49. doi: 10.1093/postmj/qgae103.

Abstract

Background: In natural disasters like earthquakes, building collapses can trap individuals, causing crush syndrome and rhabdomyolysis. This life-threatening condition often leads to acute kidney injury. We aimed to determine the effectiveness of the McMahon score in predicting mortality due to rhabdomyolysis in patients affected by the earthquake.

Methods: This is a retrospective observational study. In this study, the clinical and laboratory data of patients who presented to the emergency department due to the earthquake were analyzed. The McMahon score was calculated by evaluating factors such as creatine kinase, serum creatinine levels, age, and gender.

Results: The study included 151 patients, of whom 74 (49.0%) were male and 77 (51.0%) were female. In the univariate model, significant (P < .05) effectiveness was observed in differentiating between patients with and without mortality for McMahon score and the risk of acute kidney injury. At a McMahon score cutoff of 6, significant effectiveness was also observed, with an area under the curve of 0.723. At this cutoff value, the sensitivity was 80.0% and the specificity was 64.5%.

Conclusions: The use of the McMahon score in emergency medicine and disaster management plays a crucial role in rapid decision-making processes due to its effectiveness in predicting mortality.

Keywords: accident and emergency medicine; acute renal failure; dialysis; trauma management.

Publication types

  • Observational Study

MeSH terms

  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / mortality
  • Adult
  • Aged
  • Creatine Kinase / blood
  • Creatinine / blood
  • Crush Syndrome / complications
  • Crush Syndrome / mortality
  • Earthquakes*
  • Emergency Service, Hospital
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Rhabdomyolysis* / mortality
  • Sensitivity and Specificity
  • Severity of Illness Index

Substances

  • Creatinine
  • Creatine Kinase