RT Journal Article SR Electronic T1 Hyponatraemia in patients with crush syndrome during the Wenchuan earthquake JF Emergency Medicine Journal JO Emerg Med J FD BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine SP 745 OP 748 DO 10.1136/emermed-2012-201563 VO 30 IS 9 A1 Li Zhang A1 Ping Fu A1 Li Wang A1 Guangyan Cai A1 Lin Zhang A1 Dezheng Chen A1 Dongyang Guo A1 Xuefeng Sun A1 Fuqiong Chen A1 Weihong Bi A1 Xinjie Zeng A1 Haiyan Li A1 Zhaohui Liu A1 Yong Wang A1 Songmin Huang A1 Xiangmei Chen A1 for the Wenchuan earthquake-related AKI study group YR 2013 UL http://emj.bmj.com/content/30/9/745.abstract 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.