PT - JOURNAL ARTICLE AU - Li Zhang AU - Ping Fu AU - Li Wang AU - Guangyan Cai AU - Lin Zhang AU - Dezheng Chen AU - Dongyang Guo AU - Xuefeng Sun AU - Fuqiong Chen AU - Weihong Bi AU - Xinjie Zeng AU - Haiyan Li AU - Zhaohui Liu AU - Yong Wang AU - Songmin Huang AU - Xiangmei Chen AU - for the Wenchuan earthquake-related AKI study group TI - Hyponatraemia in patients with crush syndrome during the Wenchuan earthquake AID - 10.1136/emermed-2012-201563 DP - 2013 Sep 01 TA - Emergency Medicine Journal PG - 745--748 VI - 30 IP - 9 4099 - http://emj.bmj.com/content/30/9/745.short 4100 - http://emj.bmj.com/content/30/9/745.full SO - Emerg Med J2013 Sep 01; 30 AB - Background Although sodium disturbances are common in hospitalised patients, no study has specifically investigated the epidemiology of hyponatraemia in patients with crush syndrome. Objectives To describe the incidence of hyponatraemia and assess its effect on outcome in patients with crush syndrome during the Wenchuan earthquake. Methods A retrospective study was conducted in 17 reference hospitals during the Wenchuan earthquake. We excluded patients younger than 15 years and those with missing sodium values within 3 days after being rescued from the ruins. Results Hyponatraemia (serum sodium concentration <135 mmol/l) was seen in 91/180 (50.6%) patients on admission. Compared with patients with normonatraemia, those with hyponatraemia were younger, had more severe traumatic injury and renal failure, underwent more fasciotomies, received more blood transfusion and renal replacement therapy. In the multivariable-adjusted model, the number of extremity injuries (OR=1.59, 95% CI 1.08 to 2.33) and serum creatinine (OR=1.30, 95% CI 1.07 to 1.59) were independently associated with the occurrence of hyponatraemia. Covariate adjusted multiple logistic regression analysis showed an independent mortality risk rising with hyponatraemia (OR=5.74, 95% CI 1.18 to 28.00). Conclusions Hyponatraemia was common in the patients with crush syndrome during the Wenchuan earthquake and associated with poor prognosis. Water, commercial drinks and hypotonic intravenous fluids should be supplied carefully to patients with crush syndrome.