Drowning in Children and Predictive Parameters: A 15-Year Multicenter Retrospective Analysis.


Journal

Pediatric emergency care
ISSN: 1535-1815
Titre abrégé: Pediatr Emerg Care
Pays: United States
ID NLM: 8507560

Informations de publication

Date de publication:
01 Jul 2023
Historique:
medline: 3 7 2023
pubmed: 19 6 2023
entrez: 19 6 2023
Statut: ppublish

Résumé

Drowning is a serious and underestimated public health problem, with the highest morbidity and mortality reported among children. Data regarding pediatric outcomes of drowning are often inadequate, and data collection is poorly standardized among centers. This study aims to provide an overview of a drowning pediatric population in pediatric emergency department, focusing on its main characteristics and management and evaluating prognostic factors. This is a retrospective multicenter study involving eight Italian Pediatric Emergency Departments. Data about patients between 0 to 16 years of age who drowned between 2006 and 2021 were collected and analyzed according to the Utstein-style guidelines for drowning. One hundred thirty-five patients (60.9% males, median age at the event 5; interquartile range, 3-10) were recruited and only those with known outcome were retained for the analysis (133). Nearly 10% had a preexisting medical conditions with epilepsy being the most common comorbidity. One third were hospitalized in the intensive care unit (ICU) and younger males had a higher rate of ICU admission than female peers. Thirty-five patients (26.3%) were hospitalized in a medical ward while 19 (14.3%) were discharged from the emergency department and 11 (8.3%) were discharged after a brief medical observation less than 24 hours. Six patients died (4.5%). Medium stay in the ED was approximately 40 hours. No difference in terms of ICU admission was found between cardiopulmonary resuscitation performed by bystanders or trained medical personnel ( P = 0.388 vs 0.390). This study offers several perspectives on ED victims who drowned. One of the major finding is that no difference in outcomes was seen in patients who received cardiopulmonary resuscitation performed by bystanders or medical services, highlighting the importance of a prompt intervention.

Sections du résumé

BACKGROUND BACKGROUND
Drowning is a serious and underestimated public health problem, with the highest morbidity and mortality reported among children. Data regarding pediatric outcomes of drowning are often inadequate, and data collection is poorly standardized among centers. This study aims to provide an overview of a drowning pediatric population in pediatric emergency department, focusing on its main characteristics and management and evaluating prognostic factors.
METHODS METHODS
This is a retrospective multicenter study involving eight Italian Pediatric Emergency Departments. Data about patients between 0 to 16 years of age who drowned between 2006 and 2021 were collected and analyzed according to the Utstein-style guidelines for drowning.
RESULTS RESULTS
One hundred thirty-five patients (60.9% males, median age at the event 5; interquartile range, 3-10) were recruited and only those with known outcome were retained for the analysis (133). Nearly 10% had a preexisting medical conditions with epilepsy being the most common comorbidity. One third were hospitalized in the intensive care unit (ICU) and younger males had a higher rate of ICU admission than female peers. Thirty-five patients (26.3%) were hospitalized in a medical ward while 19 (14.3%) were discharged from the emergency department and 11 (8.3%) were discharged after a brief medical observation less than 24 hours. Six patients died (4.5%). Medium stay in the ED was approximately 40 hours. No difference in terms of ICU admission was found between cardiopulmonary resuscitation performed by bystanders or trained medical personnel ( P = 0.388 vs 0.390).
CONCLUSIONS CONCLUSIONS
This study offers several perspectives on ED victims who drowned. One of the major finding is that no difference in outcomes was seen in patients who received cardiopulmonary resuscitation performed by bystanders or medical services, highlighting the importance of a prompt intervention.

Identifiants

pubmed: 37335544
doi: 10.1097/PEC.0000000000002987
pii: 00006565-202307000-00010
doi:

Types de publication

Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

516-523

Informations de copyright

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

Déclaration de conflit d'intérêts

Disclosure: The authors declare no conflict of interest.

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Auteurs

Francesca Peri (F)

From the Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy.

Laura De Nardi (L)

From the Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy.

Arianna Canuto (A)

From the Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy.

Alberto Gaiero (A)

Pediatric and Neonatology Unit, Ospedale San Paolo Savona, Savona, Italy.

Serena Noli (S)

Department of Pediatrics, IRCCS Istituto Giannina Gaslini Institute, University of Genova, Genova, Italy.

Marta Ferretti (M)

Department of Pediatrics, IRCCS Istituto Giannina Gaslini Institute, University of Genova, Genova, Italy.

Gianluca Vergine (G)

Department of Pediatrics, Infermi Hospital Rimini, ASL Romagna, Italy.

Alice Falcioni (A)

Department of Pediatrics, Infermi Hospital Rimini, ASL Romagna, Italy.

Elisabetta Copponi (E)

Department of Pediatrics, Infermi Hospital Rimini, ASL Romagna, Italy.

Bruna Tagliabue (B)

Department of Pediatrics, University of Brescia, Brescia, Italy.

Francesco Massart (F)

Pediatric Unit, Maternal and Infant Department, Santa Chiara's University Hospital of Pisa, Pisa, Italy.

Elisabetta Fabiani (E)

Department of Pediatric Emergency, Gaspare Salesi Hospital, Azienda Ospedaliera Ospedali Riuniti, Ancona, Italy.

Carlo Stringhi (C)

Pediatric Hospital V. Buzzi, Milano, Italy.

Monica Rubini (M)

Department of Pediatric Emergency, Parma Children's Hospital, Parma, Italy.

Giulia Zamagni (G)

Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo," Trieste, Italy.

Alessandro Amaddeo (A)

Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.

Maria Rita Genovese (MR)

From the Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy.

Stefania Norbedo (S)

Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.

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