Musculoskeletal injuries and management of victims from collapsed buildings in the 2016 Taiwan earthquake: Experiences in a tertiary medical center

• Published in: Injury 2021-11, Vol.52 (11), p.3334-3339
• Main Authors: Li, Chun-Yi, Lin, Chih-Hao, Chang, Chih-Wei, Chuang, Chang-Han, Chung, Yu-Hsuan, Hu, Ming-Hsien, Lin, Cheng-Li
• Format: Article
• Language: English
• Subjects: Collapsed buildings; Earthquake; Fracture; Musculoskeletal injury; Rhabdomyolysis
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2021.08.030

•To adopt the best strategy for rescue and care, the manuscript conducts a retrospective study to compare the musculoskeletal injury pattern between the patients from collapsed building and non-collapsed building.•In the WJ group, fractures in the extremities still accounted for a large share of the injuries, but there was a significantly increased incidence of axial bone fractures compared to the control group (OR: 2.893 for vertebral fracture and 1.893 for rib fracture).•The odds ratio of rhabdomyolysis was as high as 34.73 in the WJ group, and all of the rhabdomyolysis complications in the AKI patients were in the WJ group. Patients entrapped in limited space without direct trauma during an earthquake, which can easily occur in a collapsed building, also have a non-negligible risk of rhabdomyolysis. Previous studies have seldom focused on injury patterns, especially musculoskeletal injuries, caused by building collapse during earthquakes. The aim of this study was to investigate the musculoskeletal injury profiles and management of patients rescued from collapsed buildings in the 2016 Taiwan earthquake. We conducted a retrospective study using the electronic medical record (EMR) system. We enrolled 31 patients rescued from specific collapsed buildings (the WJ group) and 56 patients injured in the same earthquake as a control group. We investigated the admission history, injury profile, treatment, and outcomes for these patients. The WJ group (51%) had significantly higher admission rates compared to the control group (25%) (p = 0.012). Although the odds ratio (OR) of fracture incidence was lower in the WJ group (OR: 0.79), there was a higher OR of multiple fractures (OR: 2.617) and axial skeletal fractures (OR: 2.893 for vertebral fracture, and OR: 1.893 ribs for rib fractures) in the WJ group. Among the 28 fracture patients, 9 (32.1%) underwent surgical interventions. A higher incidence of rhabdomyolysis was noted in the WJ group (OR: 34.73). Also, all 5 rhabdomyolysis cases combined with acute kidney injury were in the WJ group, and 1 of them required emergent hemodialysis for severe hyperkalemia. Patients extricated from collapsed buildings have a higher incidence of multiple fractures and axial skeletal fractures. More severe soft tissue injuries, including rhabdomyolysis and compartment syndrome, were also identified. The medical system should develop rescue and treatment strategies for this rare situation.