Clinical features and prognostic factors in drowning children: a regional experience.
10.3345/kjp.2016.59.5.212
- Author:
Kyung Lae SON
1
;
Su Kyeong HWANG
;
Hee Joung CHOI
Author Information
1. Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea. joung756@dsmc.or.kr
- Publication Type:Original Article
- Keywords:
Drowning;
Child;
Prognosis
- MeSH:
Alanine Transaminase;
Aspartate Aminotransferases;
Child*;
Consciousness;
Drowning*;
Female;
Humans;
Hypoxia-Ischemia, Brain;
Immersion;
Incidence;
Intubation;
Liver;
Medical Records;
Mortality;
Oxygen;
Prognosis;
Retrospective Studies;
Risk Factors;
Sodium;
Ventilators, Mechanical;
Water
- From:Korean Journal of Pediatrics
2016;59(5):212-217
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: This study aimed to evaluate the clinical features of children who have survived a water submersion incident, and to identify risk factors for prognosis. METHODS: We retrospectively reviewed the medical records of patients who experienced submersion between January 2005 and December 2014. The patients were classified into 2 groups, according to complications, and prognostic factors were evaluated. RESULTS: During the study period, 29 children experienced submersion (20 boys and 9 girls; mean age, 83.8±46.4 months). Submersion occurred most commonly in the summer, with the peak incidence in August. The most frequent Szpilman clinical score was grade 5 (13 patients; 44.8%), followed by grade 6 (7 patients; 24.1%), and grades 1 or 2 (3 patients; 10.3%). Five children (17.2%) in the poor prognosis group died or had hypoxic ischemic encephalopathy, and the overall mortality rate was 6.9%. Poor prognosis after submersion was associated with lower consciousness levels (P=0.003), higher Szpilman scores (P=0.007), greater need for intubation and mechanical ventilator support (P=0.001), and longer duration of oxygen therapy (P=0.015). Poor prognosis was also associated with lower bicarbonate levels (P=0.038), as well as higher sodium, aspartate transaminase (AST), and alanine transaminase (ALT) levels (P=0.034, P=0.006, and P=0.005, respectively). Szpilman clinical scores were positively correlated with consciousness levels (r=0.489, P=0.002) and serum liver enzyme levels (AST and ALT; r=0.521, P=0.004). CONCLUSION: We characterized the prognostic factors associated with submersion outcomes, using the Szpilman clinical score, which is comparable to consciousness level for predicting mortality.
