Rapid Prognostic Tools in Disaster Medicine: Car and Bilar in Crush Syndrome

Rapid Prognostic Tools in Disaster Medicine: Car and Bilar in Crush Syndrome | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Rapid Prognostic Tools in Disaster Medicine: Car and Bilar in Crush Syndrome Nazmiye Serap Biçer¹, Mehmet Biçer², Davut Eren³, Hilal Sipahioğlu⁴, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7312885/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 12 Nov, 2025 Read the published version in BMC Nephrology → Version 1 posted 11 You are reading this latest preprint version Abstract Background The aim of this retrospective study was to evaluate the prognostic value of the C-reactive protein-to-albumin ratio (CAR) and the bicarbonate-to-lactate ratio (BILAR) in patients who developed crush syndrome and to determine their role in predicting mortality and clinical outcomes. Materials and methods This study included patients over 18 years of age who were diagnosed with crush syndrome following the February 6, 2023 Kahramanmaraş earthquakes. Demographic, clinical, and laboratory data were analyzed. The CAR was calculated using the formula CRP (mg/L)/Albumin (g/L), while the BILAR was derived as the ratio of HCO₃ (mmol/L) to lactate (mmol/L). The primary endpoint was defined as mortality, and the secondary endpoints included amputation, intensive care unit (ICU) admission, stage 3 acute kidney injury (AKI), and the need for renal replacement therapy. The prognostic impact of CAR and BILAR indices on mortality was assessed using statistical analyses. Results: A total of 231 patients (mean age 36.63 ± 12.35 years, 51.1% female) were included, of whom 18 (7.8%) died. Mortality was significantly associated with elevated levels of BUN, creatinine, potassium, phosphorus, AST, ALT, creatine kinase, lactate, and the CAR index, as well as decreased albumin, calcium, HCO₃⁻, hemoglobin, and BILAR index values (p 3 and BILAR < 5 demonstrated strong predictive value for mortality based on their AUC scores. ROC analysis revealed that CAR showed moderate-to-good discriminative ability for mortality (AUC = 0.64), stage 3 AKI (AUC = 0.73), ICU admission (AUC = 0.75), amputation (AUC = 0.65), and the need for hemodialysis (AUC = 0.72). According to the Youden index, the optimal CAR cut-off for predicting mortality was 2.37 (sensitivity = 83%, specificity = 44%). Low BILAR values were inversely associated with all endpoints, with BILAR < 5 showing a particularly strong correlation with mortality (p < 0.001). Conclusions: CAR and BILAR are rapid and easily calculated prognostic indices in crush syndrome. Elevated CAR and decreased BILAR values at admission show a strong association with mortality and may provide valuable clinical decision support for early risk stratification and treatment planning in mass-casualty disaster settings. Crush Syndrome Mortality Earthquake Prognostic index Figures Figure 1 İNTRODUCTİON On February 6, 2023, two major earthquakes struck Türkiye, resulting in the collapse of 38,901 buildings and causing 53,537 fatalities. This disaster led to hundreds of thousands of injuries, with a substantial proportion of survivors developing crush syndrome (CS) and associated complications. Following trauma-related deaths, the leading causes of mortality were acute kidney injury (AKI), AKI-related complications, and crush syndrome itself [ 1 ]. Predicting which patients with post-earthquake CS will develop AKI or experience fatal outcomes remains clinically challenging. Several factors have been investigated as mortality predictors in such mass-casualty scenarios. Dysnatremia, duration of entrapment, elevated APACHE II scores, direct ICU admission, hemodynamic support requirements, hyperkalemia, hyperphosphatemia, elevated creatine kinase (CK), CRP, and abnormal BUN levels have been identified in previous studies as strong predictors of mortality [ 2 – 5 ]. Early prognostic indices with high sensitivity and specificity, along with robust risk scoring systems, can play a crucial role in triage and treatment planning. However, the literature on such tools in earthquake-related crush syndrome remains limited [ 6 ]. In this study, we evaluated the clinical value of alternative biomarkers that may aid in predicting mortality among individuals affected by this disaster. Specifically, we investigated the prognostic performance of the C-reactive protein-to-albumin ratio (CAR) and the bicarbonate-to-lactate ratio (BILAR). CAR is an inflammatory index with documented prognostic value in malignancies, sepsis, and acute pancreatitis. Elevated inflammatory burden reflected by a high CAR has been associated with adverse outcomes and increased mortality [ 7 , 8 ]. BILAR is defined as the ratio of serum bicarbonate (HCO₃⁻) to lactate obtained from arterial or venous blood gas analysis. It serves as a marker of tissue perfusion, particularly in critical illnesses such as shock and sepsis. A BILAR value 10 are considered indicative of compensated metabolic status and adequate oxygenation [ 9 ]. The demographic, clinical, and laboratory parameters of patients admitted to our hospital were analyzed, and groups with and without acute kidney injury (AKI) were compared. In addition, among patients requiring intensive care unit (ICU) admission and those with fatal outcomes, these indices were evaluated alongside other established mortality predictors to develop a novel and rapid risk stratification approach. METHODS Study Design and Patient Selection This retrospective observational study included patients diagnosed with crush syndrome who were treated at Kayseri City Training and Research Hospital following the February 6, 2023 Kahramanmaraş earthquakes. The diagnosis of crush syndrome required fulfillment of the following laboratory and clinical criteria: serum creatine kinase (CK) level > 1000 U/L, oliguria (daily urine output 40 mg/dL, serum creatinine > 1.5 mg/dL, serum potassium > 6 mmol/L, serum phosphorus > 8 mg/dL, and serum calcium < 8 mg/dL. The diagnosis was established based on the combination of these parameters, reflecting muscle necrosis and renal involvement, together with the clinical presentation. Patient data were retrieved from hospital records. Inclusion criteria were: age ≥ 18 years, confirmed diagnosis of crush syndrome, and complete laboratory data. Exclusion criteria included: incomplete laboratory results, transfer to another medical center, loss to follow-up, and patients younger than 18 years. Data Collection Demographic data including age and sex, clinical findings such as ICU admission, amputation, stage of acute kidney injury, and the need for dialysis, as well as laboratory parameters including CRP, albumin, HCO₃⁻, lactate, electrolytes, and complete blood count were recorded. The C-reactive protein-to-albumin ratio (CAR) was calculated using the formula CRP (mg/L) divided by albumin (g/L). The bicarbonate-to-lactate ratio (BILAR) was defined as HCO₃ (mmol/L) divided by lactate (mmol/L). The primary endpoint of the study was mortality. Secondary endpoints were the occurrence of amputation, ICU admission, progression to stage 3 acute kidney injury, and the requirement for renal replacement therapy (hemodialysis). The study was approved by the Ethics Committee of Kayseri City Training and Research Hospital (Approval No. 448, Date: May 13, 2025) and was conducted in accordance with the Declaration of Helsinki. Informed consent to participate was obtained from all participants involved in the study. Statistical Analysis The collected data were recorded and analyzed using SPSS version 22. Descriptive statistics included frequency, percentage, mean, standard deviation, median, and minimum–maximum values. Pearson’s chi-square test with Yates’ correction was used for categorical variables, and Fisher’s exact test was applied for 2x2 tables with expected counts below five. The Shapiro–Wilk test was used to assess the normality of continuous variables. For the comparison of quantitative data between independent groups, the Mann–Whitney U test was applied due to non-normal distribution. The predictive performance of the CAR and BILAR indices for primary and secondary endpoints was evaluated using Receiver Operating Characteristic (ROC) curve analysis and area under the curve (AUC) values. Optimal cut-off points were determined using the Youden index. A p-value of < 0.05 was considered statistically significant. Results Of the 231 patients included in the study, 118 (51.1%) were female and 113 (48.9%) were male. The mean age was 36.63 ± 12.35 years (range: 18–65). The most common comorbidities were hypertension (n = 22) and diabetes mellitus (n = 11). Sixteen patients (6.9%) had a single comorbidity, 41 (17.7%) had two or more, and 174 (75.3%) had no chronic conditions. During follow-up, 18 patients (7.8%) died while 213 (92.2%) survived. No significant association was found between mortality and either sex or the presence of chronic diseases (Table 1 ). Table 1 Sociodemographic characteristics and the relationship between chronic diseases and mortality Variables All Patients Exitus Right p n % n % n % Gender Female 118 51.1 12 66.7 106 49.8 0,258* Male 113 48.9 6 33.3 107 50.2 Ht None 209 90.5 14 77.8 195 91.5 0,077** Yes 22 9.5 4 22.2 18 8.5 Dm None 220 95.2 17 94.4 203 95.3 0,599** Yes 11 4.8 1 5.6 10 4.7 Chronic Disease None 174 75.3 10 55.6 164 77.0 0,076** Only 16 6.9 3 16.7 13 6.1 Two and above 41 17.7 5 27.8 36 16.9 *yates Correct (continuıty correction),**fishers exact test At admission, the most frequent injuries were extremity fractures and compartment syndrome. Ninety-six patients required intensive care unit (ICU) admission, and 70 underwent fasciotomy. Acute kidney injury (AKI) developed in 69 patients (Table 2 ). Mortality was significantly higher in patients with abdominal trauma, amputation, mechanical ventilation, ICU admission, inotropic support, and AKI (Table 2 ). Table 2 Types of trauma, interventions performed, and their relationship with mortality Variables All Patients Exitus Right p n % n % n % Extremity fracture None 148 64.1 13 72.2 135 63.4 0,621* Yes 83 35.9 5 27.8 78 36.6 Compartment syndrome None 158 68.4 9 50.0 149 70.0 0,138* Yes 73 31.6 9 50.0 64 30.0 Vertebra fracture None 192 83.1 15 83.3 177 83.1 1,000** Yes 39 16.9 3 16.7 36 16.9 Rib fracture None 195 84.4 13 72.2 182 85.4 0,169** Yes 36 15.6 5 27.8 31 14.6 Pneumothorax None 208 90.0 14 77.8 194 91.1 0,089** Yes 23 10.0 4 22.2 19 8.9 Hemothorax None 211 91.3 15 83.3 196 92.0 0,195** Yes 20 8.7 3 16.7 17 8.0 Abdominal trauma None 211 91.3 13 72.2 198 93.0 0,012** Yes 20 8.7 5 27.8 15 7.0 Head trauma None 221 95.7 17 94.4 204 95.8 0,563** Yes 10 4.3 1 5.6 9 4.2 Fasciotomy None 161 69.7 9 50.0 152 71.4 0,104* Yes 70 30.3 9 50.0 61 28.6 Hyperbaric oxygen therapy None 198 85.7 18 100.0 180 84.5 0,084** Yes 33 14.3 0 0.0 33 15.5 Amputation None 199 86.1 12 66.6 187 87.8 0,024** Yes 32 13.9 6 33.3 26 12.2 İntübation None 203 87.9 3 16.7 200 93.9 < 0,001** Yes 28 12.1 15 83.3 13 6.1 İntensive care hospitalization None 135 58.4 1 5.6 134 62.9 < 0,001* Yes 96 41.6 17 94.4 79 37.1 Service hospitalization None 15 6.5 13 72.2 2 0.9 < 0,001** Yes 216 93.5 5 27.8 211 99.1 İnotrope None 202 87.4 3 16.7 199 93.4 < 0,001** Yes 29 12.6 15 83.3 14 6.6 AKI (acute kidney injury) None 162 70.1 5 27.8 157 73.7 < 0,001* Yes 69 29.9 13 72.2 56 26.3 *Yates Correction (continuıty correction),**Fishers Exact Test Analysis of continuous variables revealed that non-survivors had significantly higher median values of BUN, creatinine, potassium, phosphorus, AST, ALT, creatine kinase, lactate, CAR, and age, while albumin, calcium, HCO₃⁻, hemoglobin, and the BILAR index were significantly lower. Sodium, chloride, CRP, WBC, and platelet counts did not differ significantly between survivors and non-survivors (Table 3 ). Table 3 Laboratory parameters and their relationship with mortality Değişkenler All Patients Exitus Right p* Ort ± sd Median Median Min-max Median Min-max BUN 29.2 ± 24.0 20.0 34.5 14–133 19.0 3-135 0,001 CREATİN 1.7 ± 1.8 0.8 1.9 0.4–4.5 0.8 0.2–13 0,018 ALB 31.3 ± 7.6 32.0 25.5 12–36 32.0 13–52 < 0,001 K 4.6 ± 0.9 4.3 5.1 3.5-8.0 4.2 3.0-7.6 0,007 NA 136.8 ± 5.9 137.0 139.0 120–151 137.0 121–165 0,390 PO4 3.9 ± 1.9 3.3 5.1 1.7–14.2 3.2 1.2–10.9 0,001 CL 103.6 ± 6.6 103.0 102.0 87–115 103.0 87–149 0,905 CA 7.6 ± 1.2 7.6 6.3 4.5–8.4 7.8 4.7–15.0 < 0,001 AST 497.9 ± 811.9 199.0 856.5 29-5351 175.0 7-6009 < 0,001 ALT 238.2 ± 446.9 106.0 370.5 18-3917 98.0 5-1710 < 0,001 CRP 109.1 ± 98.8 88.0 89.0 35–443 88.0 3.5–923 0,304 CK 30275 ± 46264 8627 60586 1023-247000 7600 332-339200 0,002 LACTATE 1.9 ± 2.2 1.4 3.3 0.6–12 1.4 0.5–24.0 < 0,001 HCO3 21.3 ± 4.2 22.0 16.9 5–28 22.0 10–30 < 0,001 Hemoglobin 11.9 ± 2.9 11.9 9.4 5.6–20.0 12.0 5.4–20.0 0,043 WBC 13.8 ± 6.5 12.0 14.0 4.5–32.0 12.0 4.0–37.0 0,136 Platelete 215.3 ± 75.9 211.0 207.5 49–423 211.0 16–495 0,943 BİLAR 16.3 ± 8.9 15.4 6.9 0.4–26.3 15.8 0.6–50.0 < 0,001 CAR 4.0 ± 4.4 3.1 3.6 1.3–27.6 3.1 0.1–40.1 0,047 Age 36.6 ± 12.4 34.0 45.0 23–63 34.0 18–65 0,015 Mann Whitney U Test The prognostic performance of the CAR and BILAR indices for mortality and secondary outcomes (stage 3 AKI, ICU admission, amputation, and the need for hemodialysis) was assessed using ROC analysis. For mortality, the area under the curve (AUC) for CAR was 0.64. The optimal cut-off point determined by the Youden index was 2.37, yielding a sensitivity of 83% and specificity of 44%. For BILAR, the AUC was 0.21, with lower values strongly associated with mortality; specifically, BILAR < 5 showed a highly significant correlation (p < 0.001) (Fig. 1 ). For stage 3 AKI, the CAR AUC was 0.73 with a cut-off of 2.37 (sensitivity = 85.5%, specificity = 53.7%), while the BILAR AUC was 0.25, with low BILAR values associated with AKI progression. For ICU admission, the CAR AUC was 0.75 with an optimal cut-off of 2.33 (sensitivity = 85.4%, specificity = 60.7%). For amputation, the CAR AUC was 0.65 with a cut-off of 2.14 (sensitivity = 90.6%, specificity = 43.7%). For the need for hemodialysis, the CAR AUC was 0.72 (cut-off = 2.37; sensitivity = 85.9%, specificity = 54.4%) (Table 4 ). Table 4 ROC analysis of the relationship between CAR and BILAR indices and primary and secondary endpoints Endpoint and Index AUC Cut-off Sensitivity Specificity Mortality-CAR 0.641 2.37 83.3% 44.1% Mortality-BILAR 0.210 51.00 0.0% 100.0% AKI Stage 3-CAR 0.726 2.37 85.5% 53.7% AKI Stage 3-BILAR 0.251 51.00 0.0% 100.0% İntensive Care-CAR 0.751 2.33 85.4% 60.7% İntensive Care-BILAR 0.336 51.00 0.0% 100.0% Amputation-CAR 0.650 2.14 90.6% 43.7% Amputation-BILAR 0.397 31.11 9.4% 93.0% Hemodialysis-CAR 0.720 2.37 85.9% 54.4% Hemodialysis-BILAR 0.280 51.00 0.0% 100.0% Overall, CAR demonstrated moderate to good prognostic performance for mortality and secondary outcomes, while low BILAR values emerged as a marker of poor prognosis. In particular, BILAR < 5 showed a statistically significant association with mortality. DİSCUSSİON The 2023 Kahramanmaraş earthquakes resulted in thousands of individuals being trapped under rubble, leading to severe systemic complications associated with crush syndrome (CS). This syndrome, driven by mechanisms such as rhabdomyolysis, hypovolemia, and reperfusion injury, significantly increases early mortality risk and represents a clinical scenario requiring urgent intervention [ 10 ]. In crush syndrome, alongside traditional biomarkers such as creatine kinase, myoglobin, and potassium, the identification of rapid and accessible biochemical indices capable of predicting mortality is of critical importance for optimizing clinical decision-making. Early identification of high-risk patients is essential for timely interventions, including fluid management and renal replacement therapy. In recent years, the use of simple, readily available biochemical ratios with a clear pathophysiological basis has been investigated as a means of predicting mortality. In this context, our study evaluated the prognostic value of the bicarbonate-to-lactate ratio (BILAR) and the C-reactive protein-to-albumin ratio (CAR) in patients with crush syndrome. The C-reactive protein-to-albumin ratio (CAR), derived from the relative levels of CRP and albumin, reflects both the severity of systemic inflammation and the nutritional status of the patient. Owing to these properties, CAR has been widely utilized as a prognostic marker of mortality in numerous critical illnesses, particularly in sepsis [ 11 ]. CAR serves as a bidirectional indicator of systemic inflammation: elevated CRP represents the positive acute-phase response and heightened proinflammatory activity, which can also contribute to vascular imbalance, vasoconstriction, and a prothrombotic state. Conversely, decreased albumin levels reflect capillary leak syndrome, malnutrition, or a catabolic response, and may exacerbate renal dysfunction through oxidative stress-induced injury. Given the inverse relationship between albumin and inflammation, this combination results in an elevated CAR in severe disease states. Accordingly, CAR has been identified as a strong prognostic biomarker in trauma, sepsis, cardiovascular events, and oncologic surgery [ 12 – 14 ]. Multiple studies have reported that CAR cut-off values are strongly associated with mortality, with area under the curve (AUC) values frequently exceeding 0.70 [ 15 – 17 ]. Consistent with these findings, our study demonstrated significantly higher CAR values among non-survivors, with the predictive performance further enhanced in cases presenting with elevated CRP and decreased albumin levels. The BILAR index provides a comprehensive assessment of tissue perfusion and metabolic balance by simultaneously reflecting the degree of metabolic acidosis through low bicarbonate (HCO₃⁻) levels and the extent of hypoperfusion via elevated lactate concentrations. In crush syndrome, systemic perfusion impairment driven by muscle necrosis, hypovolemia, and inflammatory mediators frequently leads to lactate accumulation, which is associated with adverse outcomes. In the literature, particularly in cases of sepsis and trauma, low BILAR values have been shown to correlate significantly with increased mortality [ 18 ]. For instance, conditions with bicarbonate levels ≤ 18 mmol/L and lactate ≥ 4 mmol/L have been reported to markedly increase the risk of death [ 19 ]. When assessed as a ratio, the bicarbonate-to-lactate balance has been proposed as a dynamic parameter integrating systemic hypoperfusion and metabolic reserve, with reduced values consistently linked to higher mortality across critical illness cohorts. In a study of 60 patients with acute mesenteric ischemia, an HCO₃⁻/lactate ratio ≤ 10 was a strong predictor of 30-day mortality, alongside lactate, bicarbonate, and neutrophil count [ 20 ]. Similarly, a study including 492 pediatric patients with dengue shock syndrome (DSS) in southern Vietnam evaluated the clinical utility of the lactate-to-bicarbonate (L/B) ratio, demonstrating that the L/B index provided higher prognostic value compared to lactate alone (odds ratio [OR] = 8.66, 95% CI 1.96–38.3; P < 0.01 vs. OR = 1.35, 95% CI 1.15–1.58; P < 0.001). Both the L/B and lactate models showed comparable performance [ 21 ]. In line with these findings, our study observed significantly increased mortality in patients with low BILAR values, with the index demonstrating strong discriminative ability in ROC analysis. These results, together with existing evidence, emphasize the prognostic utility of inflammatory indices such as CAR and BILAR and highlight the value of biomarker-based risk stratification in critical care settings. Our study has several limitations. First, CAR and BILAR indices were calculated based solely on laboratory values obtained at admission; therefore, their dynamic changes over time were not assessed. Second, data regarding patients’ pre-disaster nutritional status, comorbidity burden, and pre-existing organ function were insufficient, which may have introduced potential bias. Additionally, factors that could influence mortality, such as sheltering conditions, transfer times, and delays in search and rescue operations, were not available in the dataset. Furthermore, as this study was conducted using single-center data, the generalizability of the findings to other institutions and to non-disaster-related traumatic scenarios is limited. Consequently, multicenter, prospective studies are warranted to validate these results and to more robustly establish the prognostic role of CAR and BILAR indices in predicting mortality. Conclusion This study evaluated the prognostic value of the CAR (C-reactive protein-to-albumin ratio) and BILAR (bicarbonate-to-lactate ratio) indices in patients who developed crush syndrome following the February 6, 2023 Kahramanmaraş earthquakes. The findings demonstrated that elevated CAR and decreased BILAR values were significantly associated with mortality, indicating that these indices may serve as strong predictive markers. CAR reflects the combined burden of systemic inflammation and nutritional status, while BILAR provides an integrated assessment of tissue perfusion and metabolic reserve. Together, they represent rapid and easily applicable tools for risk stratification in the management of critically ill patients following mass disasters. Integrating these indices into early triage algorithms, particularly in scenarios of mass casualties and resource-limited settings, may facilitate the prompt identification of high-risk patients and support strategies aimed at reducing mortality. Multicenter, prospective studies are needed to validate these findings and further establish the clinical utility of CAR and BILAR. Declarations Acknowledgements Not applicable. Author contributions NSB: Wrote the manuscript and served as a contributing author; MB, DE, HS, BA and BO: Experimental guidance; SK: Contributed to design of the study. All authors contributed to manuscript revision, read, and approved the submitted version. Funding This report was not supported by any funding. Data availability All data generated or analysed during this study are included in this published article and its supplementary information fles. Ethics approval and consent to participate This retrospective chart review study involving human participants was approved by the Ethics Committee of Kayseri City Training and Research Hospital and conducted in accordance with the ethical standards of institutional and national research committees, as well as the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Human Ethics and Consent to Participate declarations Informed consent to participate was obtained from all participants involved in the study. Competing interests The authors declare no competing interests. Formun Altı References Long B, Liang SY, Gottlieb M. Crush injury and syndrome: a review for emergency clinicians. *Am J Emerg Med*. 2023;69:180–7. https://doi.org/10.1016/j.ajem.2023.04.029 . Yazla M, Aksoy FM. 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Cite Share Download PDF Status: Published Journal Publication published 12 Nov, 2025 Read the published version in BMC Nephrology → Version 1 posted Editorial decision: Revision requested 22 Sep, 2025 Reviews received at journal 19 Sep, 2025 Reviewers agreed at journal 10 Sep, 2025 Reviews received at journal 10 Sep, 2025 Reviewers agreed at journal 10 Sep, 2025 Reviewers agreed at journal 10 Sep, 2025 Reviewers invited by journal 29 Aug, 2025 Editor invited by journal 14 Aug, 2025 Editor assigned by journal 14 Aug, 2025 Submission checks completed at journal 13 Aug, 2025 First submitted to journal 13 Aug, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7312885","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":509953865,"identity":"ae2941f9-3de3-4213-9fdd-a0ca3da8d7c4","order_by":0,"name":"Nazmiye Serap Biçer¹","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA1ElEQVRIiWNgGAWjYLACxgYJBgb2BiDLwIIULTwHQFokiNYCJCQSQEwitMi39z78XLjDQt585vOrG34USDDwt3cn4NVicOa4sfTMMxKGc27nlN3sATpM4szZDfi1SKQxSPO2SSRISOek3eABajGQyMWvRX7+M+bfYC2SZ9Ju/iFGC8MNNjaILRLsx24TZYvBmTQ2a5BfZvDksN2WMZDgIegX+fZjzLcLd9TJS7Aff3bzzR8bOf72XgIOAwJmCMVjACYJKkfSwv6AKNWjYBSMglEw8gAAZS9A2uv1EMoAAAAASUVORK5CYII=","orcid":"","institution":"Kayseri City Hospital","correspondingAuthor":true,"prefix":"","firstName":"Nazmiye","middleName":"Serap","lastName":"Biçer¹","suffix":""},{"id":509953868,"identity":"e45a3281-7fbb-4851-b66a-c540506da55c","order_by":1,"name":"Mehmet Biçer²","email":"","orcid":"","institution":"Kayseri City Hospital","correspondingAuthor":false,"prefix":"","firstName":"Mehmet","middleName":"","lastName":"Biçer²","suffix":""},{"id":509953869,"identity":"a1f0e40c-6912-47a6-b8c5-64ab226f5475","order_by":2,"name":"Davut Eren³","email":"","orcid":"","institution":"Kayseri City Hospital","correspondingAuthor":false,"prefix":"","firstName":"Davut","middleName":"","lastName":"Eren³","suffix":""},{"id":509953870,"identity":"ddb97e45-7cb8-43a1-a0aa-424b3ba358ec","order_by":3,"name":"Hilal Sipahioğlu⁴","email":"","orcid":"","institution":"Kayseri City Hospital","correspondingAuthor":false,"prefix":"","firstName":"Hilal","middleName":"","lastName":"Sipahioğlu⁴","suffix":""},{"id":509953871,"identity":"0fb0fa2b-2a7f-4e32-a5c1-0ca9ed77caa4","order_by":4,"name":"Belgin Oral⁵","email":"","orcid":"","institution":"Kayseri City Hospital","correspondingAuthor":false,"prefix":"","firstName":"Belgin","middleName":"","lastName":"Oral⁵","suffix":""},{"id":509953872,"identity":"ac38aa71-1ba5-4010-98a6-98ddaabeed89","order_by":5,"name":"Banu Açmaz¹","email":"","orcid":"","institution":"Kayseri City Hospital","correspondingAuthor":false,"prefix":"","firstName":"Banu","middleName":"","lastName":"Açmaz¹","suffix":""},{"id":509953873,"identity":"82444753-795e-4429-9d93-850182777e48","order_by":6,"name":"Sümeyra Koyuncu³","email":"","orcid":"","institution":"Kayseri City Hospital","correspondingAuthor":false,"prefix":"","firstName":"Sümeyra","middleName":"","lastName":"Koyuncu³","suffix":""}],"badges":[],"createdAt":"2025-08-06 20:38:08","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7312885/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7312885/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12882-025-04548-8","type":"published","date":"2025-11-12T15:58:46+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":90804912,"identity":"b699e95e-d820-4e92-be51-4c4dd9642459","added_by":"auto","created_at":"2025-09-08 10:40:54","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":43130,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eROC Curves Evaluating the Predictive Performance of CAR and BILAR Indices for Mortality\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eReceiver Operating Characteristic (ROC) curves demonstrating the prognostic value of CAR and BILAR indices in predicting mortality among patients with crush syndrome.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"Picture1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7312885/v1/63c299c5f3ce083ff3c0baef.jpg"},{"id":96105170,"identity":"27d51bac-818e-42ee-aa9f-57d20ae1b4c5","added_by":"auto","created_at":"2025-11-17 16:09:36","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1035585,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7312885/v1/fd306d67-1aa2-4c2b-a56c-da74cb3e0e58.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eRapid Prognostic Tools in Disaster Medicine: Car and Bilar in Crush Syndrome\u003c/p\u003e","fulltext":[{"header":"İNTRODUCTİON","content":"\u003cp\u003eOn February 6, 2023, two major earthquakes struck T\u0026uuml;rkiye, resulting in the collapse of 38,901 buildings and causing 53,537 fatalities. This disaster led to hundreds of thousands of injuries, with a substantial proportion of survivors developing crush syndrome (CS) and associated complications. Following trauma-related deaths, the leading causes of mortality were acute kidney injury (AKI), AKI-related complications, and crush syndrome itself [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].\u003c/p\u003e\u003cp\u003ePredicting which patients with post-earthquake CS will develop AKI or experience fatal outcomes remains clinically challenging. Several factors have been investigated as mortality predictors in such mass-casualty scenarios. Dysnatremia, duration of entrapment, elevated APACHE II scores, direct ICU admission, hemodynamic support requirements, hyperkalemia, hyperphosphatemia, elevated creatine kinase (CK), CRP, and abnormal BUN levels have been identified in previous studies as strong predictors of mortality [\u003cspan additionalcitationids=\"CR3 CR4\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eEarly prognostic indices with high sensitivity and specificity, along with robust risk scoring systems, can play a crucial role in triage and treatment planning. However, the literature on such tools in earthquake-related crush syndrome remains limited [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn this study, we evaluated the clinical value of alternative biomarkers that may aid in predicting mortality among individuals affected by this disaster. Specifically, we investigated the prognostic performance of the C-reactive protein-to-albumin ratio (CAR) and the bicarbonate-to-lactate ratio (BILAR). CAR is an inflammatory index with documented prognostic value in malignancies, sepsis, and acute pancreatitis. Elevated inflammatory burden reflected by a high CAR has been associated with adverse outcomes and increased mortality [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eBILAR is defined as the ratio of serum bicarbonate (HCO₃⁻) to lactate obtained from arterial or venous blood gas analysis. It serves as a marker of tissue perfusion, particularly in critical illnesses such as shock and sepsis. A BILAR value\u0026thinsp;\u0026lt;\u0026thinsp;5 has been linked to hypoperfusion, shock, multi-organ failure, and increased mortality, whereas values\u0026thinsp;\u0026gt;\u0026thinsp;10 are considered indicative of compensated metabolic status and adequate oxygenation [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe demographic, clinical, and laboratory parameters of patients admitted to our hospital were analyzed, and groups with and without acute kidney injury (AKI) were compared. In addition, among patients requiring intensive care unit (ICU) admission and those with fatal outcomes, these indices were evaluated alongside other established mortality predictors to develop a novel and rapid risk stratification approach.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eStudy Design and Patient Selection\u003c/h2\u003e\u003cp\u003eThis retrospective observational study included patients diagnosed with crush syndrome who were treated at Kayseri City Training and Research Hospital following the February 6, 2023 Kahramanmaraş earthquakes. The diagnosis of crush syndrome required fulfillment of the following laboratory and clinical criteria: serum creatine kinase (CK) level\u0026thinsp;\u0026gt;\u0026thinsp;1000 U/L, oliguria (daily urine output\u0026thinsp;\u0026lt;\u0026thinsp;400 mL), blood urea nitrogen (BUN)\u0026thinsp;\u0026gt;\u0026thinsp;40 mg/dL, serum creatinine\u0026thinsp;\u0026gt;\u0026thinsp;1.5 mg/dL, serum potassium\u0026thinsp;\u0026gt;\u0026thinsp;6 mmol/L, serum phosphorus\u0026thinsp;\u0026gt;\u0026thinsp;8 mg/dL, and serum calcium\u0026thinsp;\u0026lt;\u0026thinsp;8 mg/dL. The diagnosis was established based on the combination of these parameters, reflecting muscle necrosis and renal involvement, together with the clinical presentation.\u003c/p\u003e\u003cp\u003ePatient data were retrieved from hospital records. Inclusion criteria were: age\u0026thinsp;\u0026ge;\u0026thinsp;18 years, confirmed diagnosis of crush syndrome, and complete laboratory data. Exclusion criteria included: incomplete laboratory results, transfer to another medical center, loss to follow-up, and patients younger than 18 years.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eData Collection\u003c/h3\u003e\n\u003cp\u003eDemographic data including age and sex, clinical findings such as ICU admission, amputation, stage of acute kidney injury, and the need for dialysis, as well as laboratory parameters including CRP, albumin, HCO₃⁻, lactate, electrolytes, and complete blood count were recorded. The C-reactive protein-to-albumin ratio (CAR) was calculated using the formula CRP (mg/L) divided by albumin (g/L). The bicarbonate-to-lactate ratio (BILAR) was defined as HCO₃ (mmol/L) divided by lactate (mmol/L). The primary endpoint of the study was mortality. Secondary endpoints were the occurrence of amputation, ICU admission, progression to stage 3 acute kidney injury, and the requirement for renal replacement therapy (hemodialysis). The study was approved by the Ethics Committee of Kayseri City Training and Research Hospital (Approval No. 448, Date: May 13, 2025) and was conducted in accordance with the Declaration of Helsinki. Informed consent to participate was obtained from all participants involved in the study.\u003c/p\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003eStatistical Analysis\u003c/h2\u003e\u003cp\u003eThe collected data were recorded and analyzed using SPSS version 22. Descriptive statistics included frequency, percentage, mean, standard deviation, median, and minimum\u0026ndash;maximum values. Pearson\u0026rsquo;s chi-square test with Yates\u0026rsquo; correction was used for categorical variables, and Fisher\u0026rsquo;s exact test was applied for 2x2 tables with expected counts below five. The Shapiro\u0026ndash;Wilk test was used to assess the normality of continuous variables.\u003c/p\u003e\u003cp\u003eFor the comparison of quantitative data between independent groups, the Mann\u0026ndash;Whitney U test was applied due to non-normal distribution. The predictive performance of the CAR and BILAR indices for primary and secondary endpoints was evaluated using Receiver Operating Characteristic (ROC) curve analysis and area under the curve (AUC) values. Optimal cut-off points were determined using the Youden index. A p-value of \u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eOf the 231 patients included in the study, 118 (51.1%) were female and 113 (48.9%) were male. The mean age was 36.63\u0026thinsp;\u0026plusmn;\u0026thinsp;12.35 years (range: 18\u0026ndash;65). The most common comorbidities were hypertension (n\u0026thinsp;=\u0026thinsp;22) and diabetes mellitus (n\u0026thinsp;=\u0026thinsp;11). Sixteen patients (6.9%) had a single comorbidity, 41 (17.7%) had two or more, and 174 (75.3%) had no chronic conditions. During follow-up, 18 patients (7.8%) died while 213 (92.2%) survived. No significant association was found between mortality and either sex or the presence of chronic diseases (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSociodemographic characteristics and the relationship between chronic diseases and mortality\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eAll Patients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003eExitus\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003eRight\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003en\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003en\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003en\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e118\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e51.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e66.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e106\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e49.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0,258*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e113\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e48.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" 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morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eDm\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e220\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e95.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e94.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e203\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e95.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0,599**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e4.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eChronic Disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e174\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e75.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e55.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e164\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e77.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0,076**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOnly\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e16.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e6.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTwo and above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e27.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e16.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"9\"\u003e*yates Correct (continuıty correction),**fishers exact test\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eAt admission, the most frequent injuries were extremity fractures and compartment syndrome. Ninety-six patients required intensive care unit (ICU) admission, and 70 underwent fasciotomy. Acute kidney injury (AKI) developed in 69 patients (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Mortality was significantly higher in patients with abdominal trauma, amputation, mechanical ventilation, ICU admission, inotropic support, and AKI (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eTypes of trauma, interventions performed, and their relationship with mortality\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eAll Patients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003eExitus\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003eRight\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003en\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003en\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003en\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eExtremity fracture\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e148\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e64.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e72.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e135\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e63.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0,621*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e27.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e36.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eCompartment syndrome\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e158\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e68.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e50.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e149\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e70.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0,138*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e31.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e50.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e30.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eVertebra fracture\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e192\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e83.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e83.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e177\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e83.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e1,000**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e16.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e16.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eRib fracture\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e195\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e84.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e72.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e182\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e85.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0,169**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e15.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e27.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e14.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ePneumothorax\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e208\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e90.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e77.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e194\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e91.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0,089**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e22.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e8.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eHemothorax\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e211\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e91.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e83.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e196\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e92.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0,195**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e16.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e8.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eAbdominal trauma\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e211\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e91.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e72.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e198\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e93.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0,012**\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e27.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e7.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eHead trauma\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e221\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e95.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e94.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e204\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e95.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0,563**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e4.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eFasciotomy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e161\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e69.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e50.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e152\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e71.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0,104*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e30.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e50.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e28.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eHyperbaric oxygen therapy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e198\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e85.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e100.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e180\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e84.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0,084**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e15.5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eAmputation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e199\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e86.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e66.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e187\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e87.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e0,024**\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e13.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e33.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e12.2\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eİnt\u0026uuml;bation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e203\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e87.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e16.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e200\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e93.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001**\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e83.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e6.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eİntensive care hospitalization\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e135\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e58.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e134\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e62.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e41.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e94.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e37.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eService hospitalization\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e72.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001**\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e216\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e93.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e27.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e211\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e99.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eİnotrope\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e202\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e87.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e16.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e199\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e93.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001**\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e83.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e6.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eAKI (acute kidney injury)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e162\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e70.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e27.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e157\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e73.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e29.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e72.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e26.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"9\"\u003e*Yates Correction (continuıty correction),**Fishers Exact Test\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eAnalysis of continuous variables revealed that non-survivors had significantly higher median values of BUN, creatinine, potassium, phosphorus, AST, ALT, creatine kinase, lactate, CAR, and age, while albumin, calcium, HCO₃⁻, hemoglobin, and the BILAR index were significantly lower. Sodium, chloride, CRP, WBC, and platelet counts did not differ significantly between survivors and non-survivors (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eLaboratory parameters and their relationship with mortality\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eDeğişkenler\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eAll Patients\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003eExitus\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u003cp\u003eRight\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ep*\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOrt\u0026thinsp;\u0026plusmn;\u0026thinsp;sd\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMedian\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMedian\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eMin-max\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eMedian\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eMin-max\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBUN\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e29.2\u0026thinsp;\u0026plusmn;\u0026thinsp;24.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e34.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e14\u0026ndash;133\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e19.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3-135\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e0,001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCREATİN\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e1.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.4\u0026ndash;4.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.2\u0026ndash;13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e0,018\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eALB\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e31.3\u0026thinsp;\u0026plusmn;\u0026thinsp;7.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e32.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e25.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e12\u0026ndash;36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e32.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e13\u0026ndash;52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eK\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e4.6\u0026thinsp;\u0026plusmn;\u0026thinsp;0.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.5-8.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e4.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3.0-7.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e0,007\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e136.8\u0026thinsp;\u0026plusmn;\u0026thinsp;5.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e137.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e139.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e120\u0026ndash;151\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e137.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e121\u0026ndash;165\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0,390\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePO4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.7\u0026ndash;14.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1.2\u0026ndash;10.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e0,001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCL\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e103.6\u0026thinsp;\u0026plusmn;\u0026thinsp;6.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e103.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e102.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e87\u0026ndash;115\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e103.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e87\u0026ndash;149\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0,905\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e7.6\u0026thinsp;\u0026plusmn;\u0026thinsp;1.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4.5\u0026ndash;8.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e7.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e4.7\u0026ndash;15.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAST\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e497.9\u0026thinsp;\u0026plusmn;\u0026thinsp;811.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e199.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e856.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e29-5351\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e175.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e7-6009\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eALT\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e238.2\u0026thinsp;\u0026plusmn;\u0026thinsp;446.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e106.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e370.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e18-3917\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e98.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e5-1710\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCRP\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e109.1\u0026thinsp;\u0026plusmn;\u0026thinsp;98.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e88.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e89.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e35\u0026ndash;443\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e88.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3.5\u0026ndash;923\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0,304\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCK\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e30275\u0026thinsp;\u0026plusmn;\u0026thinsp;46264\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8627\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e60586\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1023-247000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e7600\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e332-339200\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e0,002\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLACTATE\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e1.9\u0026thinsp;\u0026plusmn;\u0026thinsp;2.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.6\u0026ndash;12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.5\u0026ndash;24.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHCO3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e21.3\u0026thinsp;\u0026plusmn;\u0026thinsp;4.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e22.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e5\u0026ndash;28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e22.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e10\u0026ndash;30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHemoglobin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e11.9\u0026thinsp;\u0026plusmn;\u0026thinsp;2.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e5.6\u0026ndash;20.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e12.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e5.4\u0026ndash;20.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e0,043\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWBC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e13.8\u0026thinsp;\u0026plusmn;\u0026thinsp;6.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4.5\u0026ndash;32.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e12.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e4.0\u0026ndash;37.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0,136\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePlatelete\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e215.3\u0026thinsp;\u0026plusmn;\u0026thinsp;75.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e211.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e207.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e49\u0026ndash;423\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e211.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e16\u0026ndash;495\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0,943\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBİLAR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e16.3\u0026thinsp;\u0026plusmn;\u0026thinsp;8.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.4\u0026ndash;26.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e15.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.6\u0026ndash;50.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0,001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCAR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e4.0\u0026thinsp;\u0026plusmn;\u0026thinsp;4.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.3\u0026ndash;27.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.1\u0026ndash;40.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e0,047\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e36.6\u0026thinsp;\u0026plusmn;\u0026thinsp;12.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e34.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e45.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e23\u0026ndash;63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e34.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e18\u0026ndash;65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e\u003cb\u003e0,015\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"8\"\u003eMann Whitney U Test\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe prognostic performance of the CAR and BILAR indices for mortality and secondary outcomes (stage 3 AKI, ICU admission, amputation, and the need for hemodialysis) was assessed using ROC analysis. For mortality, the area under the curve (AUC) for CAR was 0.64. The optimal cut-off point determined by the Youden index was 2.37, yielding a sensitivity of 83% and specificity of 44%. For BILAR, the AUC was 0.21, with lower values strongly associated with mortality; specifically, BILAR\u0026thinsp;\u0026lt;\u0026thinsp;5 showed a highly significant correlation (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eFor stage 3 AKI, the CAR AUC was 0.73 with a cut-off of 2.37 (sensitivity\u0026thinsp;=\u0026thinsp;85.5%, specificity\u0026thinsp;=\u0026thinsp;53.7%), while the BILAR AUC was 0.25, with low BILAR values associated with AKI progression. For ICU admission, the CAR AUC was 0.75 with an optimal cut-off of 2.33 (sensitivity\u0026thinsp;=\u0026thinsp;85.4%, specificity\u0026thinsp;=\u0026thinsp;60.7%). For amputation, the CAR AUC was 0.65 with a cut-off of 2.14 (sensitivity\u0026thinsp;=\u0026thinsp;90.6%, specificity\u0026thinsp;=\u0026thinsp;43.7%). For the need for hemodialysis, the CAR AUC was 0.72 (cut-off =\u0026thinsp;2.37; sensitivity\u0026thinsp;=\u0026thinsp;85.9%, specificity\u0026thinsp;=\u0026thinsp;54.4%) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eROC analysis of the relationship between CAR and BILAR indices and primary and secondary endpoints\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEndpoint and Index\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAUC\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eCut-off\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSensitivity\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eSpecificity\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMortality-CAR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.641\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e83.3%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e44.1%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMortality-BILAR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.210\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e51.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e100.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAKI Stage 3-CAR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.726\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e85.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e53.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAKI Stage 3-BILAR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.251\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e51.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e100.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eİntensive Care-CAR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.751\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e85.4%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e60.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eİntensive Care-BILAR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.336\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e51.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e100.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAmputation-CAR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.650\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e90.6%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e43.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAmputation-BILAR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.397\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e31.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e9.4%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e93.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHemodialysis-CAR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.720\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e85.9%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e54.4%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHemodialysis-BILAR\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.280\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e51.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e100.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eOverall, CAR demonstrated moderate to good prognostic performance for mortality and secondary outcomes, while low BILAR values emerged as a marker of poor prognosis. In particular, BILAR\u0026thinsp;\u0026lt;\u0026thinsp;5 showed a statistically significant association with mortality.\u003c/p\u003e"},{"header":"DİSCUSSİON","content":"\u003cp\u003eThe 2023 Kahramanmaraş earthquakes resulted in thousands of individuals being trapped under rubble, leading to severe systemic complications associated with crush syndrome (CS). This syndrome, driven by mechanisms such as rhabdomyolysis, hypovolemia, and reperfusion injury, significantly increases early mortality risk and represents a clinical scenario requiring urgent intervention [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn crush syndrome, alongside traditional biomarkers such as creatine kinase, myoglobin, and potassium, the identification of rapid and accessible biochemical indices capable of predicting mortality is of critical importance for optimizing clinical decision-making. Early identification of high-risk patients is essential for timely interventions, including fluid management and renal replacement therapy.\u003c/p\u003e\u003cp\u003eIn recent years, the use of simple, readily available biochemical ratios with a clear pathophysiological basis has been investigated as a means of predicting mortality. In this context, our study evaluated the prognostic value of the bicarbonate-to-lactate ratio (BILAR) and the C-reactive protein-to-albumin ratio (CAR) in patients with crush syndrome.\u003c/p\u003e\u003cp\u003eThe C-reactive protein-to-albumin ratio (CAR), derived from the relative levels of CRP and albumin, reflects both the severity of systemic inflammation and the nutritional status of the patient. Owing to these properties, CAR has been widely utilized as a prognostic marker of mortality in numerous critical illnesses, particularly in sepsis [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eCAR serves as a bidirectional indicator of systemic inflammation: elevated CRP represents the positive acute-phase response and heightened proinflammatory activity, which can also contribute to vascular imbalance, vasoconstriction, and a prothrombotic state. Conversely, decreased albumin levels reflect capillary leak syndrome, malnutrition, or a catabolic response, and may exacerbate renal dysfunction through oxidative stress-induced injury. Given the inverse relationship between albumin and inflammation, this combination results in an elevated CAR in severe disease states.\u003c/p\u003e\u003cp\u003eAccordingly, CAR has been identified as a strong prognostic biomarker in trauma, sepsis, cardiovascular events, and oncologic surgery [\u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Multiple studies have reported that CAR cut-off values are strongly associated with mortality, with area under the curve (AUC) values frequently exceeding 0.70 [\u003cspan additionalcitationids=\"CR16\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Consistent with these findings, our study demonstrated significantly higher CAR values among non-survivors, with the predictive performance further enhanced in cases presenting with elevated CRP and decreased albumin levels.\u003c/p\u003e\u003cp\u003eThe BILAR index provides a comprehensive assessment of tissue perfusion and metabolic balance by simultaneously reflecting the degree of metabolic acidosis through low bicarbonate (HCO₃⁻) levels and the extent of hypoperfusion via elevated lactate concentrations. In crush syndrome, systemic perfusion impairment driven by muscle necrosis, hypovolemia, and inflammatory mediators frequently leads to lactate accumulation, which is associated with adverse outcomes.\u003c/p\u003e\u003cp\u003eIn the literature, particularly in cases of sepsis and trauma, low BILAR values have been shown to correlate significantly with increased mortality [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. For instance, conditions with bicarbonate levels\u0026thinsp;\u0026le;\u0026thinsp;18 mmol/L and lactate\u0026thinsp;\u0026ge;\u0026thinsp;4 mmol/L have been reported to markedly increase the risk of death [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. When assessed as a ratio, the bicarbonate-to-lactate balance has been proposed as a dynamic parameter integrating systemic hypoperfusion and metabolic reserve, with reduced values consistently linked to higher mortality across critical illness cohorts.\u003c/p\u003e\u003cp\u003eIn a study of 60 patients with acute mesenteric ischemia, an HCO₃⁻/lactate ratio\u0026thinsp;\u0026le;\u0026thinsp;10 was a strong predictor of 30-day mortality, alongside lactate, bicarbonate, and neutrophil count [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Similarly, a study including 492 pediatric patients with dengue shock syndrome (DSS) in southern Vietnam evaluated the clinical utility of the lactate-to-bicarbonate (L/B) ratio, demonstrating that the L/B index provided higher prognostic value compared to lactate alone (odds ratio [OR]\u0026thinsp;=\u0026thinsp;8.66, 95% CI 1.96\u0026ndash;38.3; P\u0026thinsp;\u0026lt;\u0026thinsp;0.01 vs. OR\u0026thinsp;=\u0026thinsp;1.35, 95% CI 1.15\u0026ndash;1.58; P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Both the L/B and lactate models showed comparable performance [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn line with these findings, our study observed significantly increased mortality in patients with low BILAR values, with the index demonstrating strong discriminative ability in ROC analysis. These results, together with existing evidence, emphasize the prognostic utility of inflammatory indices such as CAR and BILAR and highlight the value of biomarker-based risk stratification in critical care settings.\u003c/p\u003e\u003cp\u003eOur study has several limitations. First, CAR and BILAR indices were calculated based solely on laboratory values obtained at admission; therefore, their dynamic changes over time were not assessed. Second, data regarding patients\u0026rsquo; pre-disaster nutritional status, comorbidity burden, and pre-existing organ function were insufficient, which may have introduced potential bias. Additionally, factors that could influence mortality, such as sheltering conditions, transfer times, and delays in search and rescue operations, were not available in the dataset.\u003c/p\u003e\u003cp\u003eFurthermore, as this study was conducted using single-center data, the generalizability of the findings to other institutions and to non-disaster-related traumatic scenarios is limited. Consequently, multicenter, prospective studies are warranted to validate these results and to more robustly establish the prognostic role of CAR and BILAR indices in predicting mortality.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study evaluated the prognostic value of the CAR (C-reactive protein-to-albumin ratio) and BILAR (bicarbonate-to-lactate ratio) indices in patients who developed crush syndrome following the February 6, 2023 Kahramanmaraş earthquakes. The findings demonstrated that elevated CAR and decreased BILAR values were significantly associated with mortality, indicating that these indices may serve as strong predictive markers.\u003c/p\u003e\u003cp\u003eCAR reflects the combined burden of systemic inflammation and nutritional status, while BILAR provides an integrated assessment of tissue perfusion and metabolic reserve. Together, they represent rapid and easily applicable tools for risk stratification in the management of critically ill patients following mass disasters.\u003c/p\u003e\u003cp\u003eIntegrating these indices into early triage algorithms, particularly in scenarios of mass casualties and resource-limited settings, may facilitate the prompt identification of high-risk patients and support strategies aimed at reducing mortality. Multicenter, prospective studies are needed to validate these findings and further establish the clinical utility of CAR and BILAR.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; Not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Author contributions\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNSB:\u0026nbsp;Wrote the manuscript and served as a contributing author; MB, DE, HS, BA and BO: Experimental guidance; SK: Contributed to design of the study. All authors contributed to manuscript revision, read, and approved the submitted version.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Funding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis report was not supported by any funding.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;All data generated or analysed during this study are included in this published article and its supplementary information fles.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Ethics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;This retrospective chart review study involving human participants was approved by the Ethics Committee of Kayseri City Training and Research Hospital and conducted in accordance with the ethical standards of institutional and national research committees, as well as the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHuman Ethics and Consent to Participate declarations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent to participate was obtained from all participants involved in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003eFormun Altı\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eLong B, Liang SY, Gottlieb M. 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Apr 26) Prognostic values of serum lactatetobicarbonate ratio and lactate for predicting 28day inhospital mortality in children with dengue shock syndrome. *Medicine (Baltimore)*. 2024;103(17):e38000. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/MD.0000000000038000\u003c/span\u003e\u003cspan address=\"10.1097/MD.0000000000038000\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nephrology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bnep","sideBox":"Learn more about [BMC Nephrology](http://bmcnephrol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bnep/default.aspx","title":"BMC Nephrology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Crush Syndrome, Mortality, Earthquake, Prognostic index","lastPublishedDoi":"10.21203/rs.3.rs-7312885/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7312885/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eThe aim of this retrospective study was to evaluate the prognostic value of the C-reactive protein-to-albumin ratio (CAR) and the bicarbonate-to-lactate ratio (BILAR) in patients who developed crush syndrome and to determine their role in predicting mortality and clinical outcomes.\u003c/p\u003e\u003ch2\u003eMaterials and methods\u003c/h2\u003e\u003cp\u003eThis study included patients over 18 years of age who were diagnosed with crush syndrome following the February 6, 2023 Kahramanmaraş earthquakes. Demographic, clinical, and laboratory data were analyzed. The CAR was calculated using the formula CRP (mg/L)/Albumin (g/L), while the BILAR was derived as the ratio of HCO₃ (mmol/L) to lactate (mmol/L). The primary endpoint was defined as mortality, and the secondary endpoints included amputation, intensive care unit (ICU) admission, stage 3 acute kidney injury (AKI), and the need for renal replacement therapy. The prognostic impact of CAR and BILAR indices on mortality was assessed using statistical analyses.\u003c/p\u003e\u003ch2\u003eResults:\u003c/h2\u003e\u003cp\u003eA total of 231 patients (mean age 36.63\u0026thinsp;\u0026plusmn;\u0026thinsp;12.35 years, 51.1% female) were included, of whom 18 (7.8%) died. Mortality was significantly associated with elevated levels of BUN, creatinine, potassium, phosphorus, AST, ALT, creatine kinase, lactate, and the CAR index, as well as decreased albumin, calcium, HCO₃⁻, hemoglobin, and BILAR index values (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). CAR\u0026thinsp;\u0026gt;\u0026thinsp;3 and BILAR\u0026thinsp;\u0026lt;\u0026thinsp;5 demonstrated strong predictive value for mortality based on their AUC scores. ROC analysis revealed that CAR showed moderate-to-good discriminative ability for mortality (AUC\u0026thinsp;=\u0026thinsp;0.64), stage 3 AKI (AUC\u0026thinsp;=\u0026thinsp;0.73), ICU admission (AUC\u0026thinsp;=\u0026thinsp;0.75), amputation (AUC\u0026thinsp;=\u0026thinsp;0.65), and the need for hemodialysis (AUC\u0026thinsp;=\u0026thinsp;0.72). According to the Youden index, the optimal CAR cut-off for predicting mortality was 2.37 (sensitivity\u0026thinsp;=\u0026thinsp;83%, specificity\u0026thinsp;=\u0026thinsp;44%). Low BILAR values were inversely associated with all endpoints, with BILAR\u0026thinsp;\u0026lt;\u0026thinsp;5 showing a particularly strong correlation with mortality (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003ch2\u003eConclusions:\u003c/h2\u003e\u003cp\u003eCAR and BILAR are rapid and easily calculated prognostic indices in crush syndrome. Elevated CAR and decreased BILAR values at admission show a strong association with mortality and may provide valuable clinical decision support for early risk stratification and treatment planning in mass-casualty disaster settings.\u003c/p\u003e","manuscriptTitle":"Rapid Prognostic Tools in Disaster Medicine: Car and Bilar in Crush Syndrome","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-08 10:40:48","doi":"10.21203/rs.3.rs-7312885/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-09-22T05:05:32+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-19T11:49:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"134347078522482849726231932691899948947","date":"2025-09-10T13:59:07+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-10T11:12:39+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"125542676809160805554643801196415005516","date":"2025-09-10T09:49:50+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"42760434816101432943792823510784878950","date":"2025-09-10T05:26:47+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-08-29T04:51:34+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-08-14T11:23:11+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-08-14T11:16:50+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-08-13T22:17:50+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nephrology","date":"2025-08-13T22:15:15+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nephrology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bnep","sideBox":"Learn more about [BMC Nephrology](http://bmcnephrol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bnep/default.aspx","title":"BMC Nephrology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5001bf04-b6a9-4871-b46a-b6eb07ad2e21","owner":[],"postedDate":"September 8th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-11-17T16:04:22+00:00","versionOfRecord":{"articleIdentity":"rs-7312885","link":"https://doi.org/10.1186/s12882-025-04548-8","journal":{"identity":"bmc-nephrology","isVorOnly":false,"title":"BMC Nephrology"},"publishedOn":"2025-11-12 15:58:46","publishedOnDateReadable":"November 12th, 2025"},"versionCreatedAt":"2025-09-08 10:40:48","video":"","vorDoi":"10.1186/s12882-025-04548-8","vorDoiUrl":"https://doi.org/10.1186/s12882-025-04548-8","workflowStages":[]},"version":"v1","identity":"rs-7312885","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7312885","identity":"rs-7312885","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}