Pediatr Emerg Med J.  2021 Dec;8(2):66-72. 10.22470/pemj.2021.00304.

Outcome prediction of pediatric drowning

• Park MS
• Seo WH
• Je BK
• Song DJ
• Kwon JH

• KMID: 2523997
• DOI: http://doi.org/10.22470/pemj.2021.00304

Abstract

Purpose
Despite the well-known mortality of pediatric drowning, there is a paucity of evidence on the implications of an initial evaluation on the relevant outcome of drowning. This study aimed to investigate the association of initial clinical findings with outcome of children undergoing drowning.
Methods
This retrospective study was conducted using the medical records of 56 children undergoing drowning who visited 3 Korean academic hospitals from January 2000 through May 2020. We analyzed information regarding the prehospital resuscitation, drowning time, a 4-tiered chest radiographic grade, and the baseline characteristics. The grade was defined based on the findings of initial chest radiographs. The poor outcomes were defined as the need for intensive care unit care or death aftercare. We analyzed the association of the prehospital resuscitation, submersion time, and the radiographic grade with the poor outcomes using binary logistic regression.
Results
Among the 56 children, 31 (55.4%) were aged 1-4 years. Prehospital resuscitation and 1-5 minutes of submersion time were noted in the 25 (44.6%) and 30 children (53.6%), respectively. The chest radiographic grades 1 through 4 accounted for 17 (30.4%), 20 (35.7%), 12 (21.4%), and 3 children (5.4%), respectively. Poor outcomes occurred in 17 children (30.4%), including 3 deaths (5.4%). The association with the poor outcomes was noted in the submersion time of longer than 5 minutes (adjusted odds ratio, 21.49; 95% confidence interval, 1.11-415.73; compared with < 1 minute) while not in the submersion time and chest radiographic grade.
Conclusion
This study confirms that submersion time is an outcome predictor of drowning.

Keyword

Drowning; Pediatrics; Prognosis; Resuscitation; X-Rays

Figure

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  Fig. 1. A 4-tiered chest radiographic grade. The following radiographs show a normal finding in a 2-year-old girl (grade 1, A), increased interstitial markings in a 3-year-old boy (grade 2, B), ground glass opacities with increased interstitial markings in a 1-year-old boy (grade 3), and numerous patchy consolidations in a 4-year-old girl (grade 4, D).

Reference

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