The Incidence of Signs of Renal Injury Following Prolonged Burial Under Debris in an Unselected Series of 764 AIr‐raid Casualties Admitted to Hospital

Summary U rinary signs suggestive of renal damage following prolonged burial under debris were observed in 8 (1.05 per cent.) of a random group of 764 air‐raid casualties admitted to hospital. These 764 people were the total of all casualties admitted to hospital in twelve raids on six towns. Only 3 of the 8 casualties with urinary abnormalities died. The suppression of renal secretion in 1 of the 3 fatal cases was due to heart failure and hæmoconcentration following paralytic ileus, and in a second fatal casualty it is probable that hæmaturia was due to direct renal trauma. The incidence among all air‐raid casualties of urinary signs of renal damage following crushing injury is thus 0.78 per cent. This figure is considerably lower than the estimate of 5 per cent. made by Bywaters (1942) for the incidence of “crush syndrome” among air‐raid casualties in urban areas. The 6 casualties who, in view of urinary signs such as albuminuria or myohæmoglobinuria, may be classified as cases of “crush syndrome,” represent 7.8 per cent of a total of 77 individuals in this series of 764 air‐raid casualties who were buried under debris for more than two hours.