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An analysis of prognostic factors for submersion accidents in children
1Department of Pediatrics, Changhua Christian Hospital, Taiwan, R.O.C.
Insights
This study on pediatric drowning victims found that young males in summer are most affected. Favorable prognostic factors include higher body temperature and detectable vital signs upon arrival.
Area of Science:
- Pediatrics
- Emergency Medicine
- Public Health
Background:
- Pediatric submersion injuries pose a significant public health challenge.
- Understanding risk factors and prognostic indicators is crucial for improving outcomes.
Purpose of the Study:
- To retrospectively analyze pediatric submersion victims.
- To identify characteristics of affected children and factors influencing outcomes.
Main Methods:
- Retrospective review of 47 pediatric submersion cases (1983-1990).
- Analysis of patient demographics, submersion details, and initial clinical status.
- Evaluation of prognostic scoring systems (Orlowski score, modified PSI).
Main Results:
- Most victims were males (74%) under three years old (64%), with fishpool submersion (60%) in summer (45%).
- No significant differences in submersion time or CPR were found between survival and death groups.
- Favorable prognostic factors included body temperature >35°C, detectable heartbeat/respiration, Orlowski score <2, and PSI <7.
Conclusions:
- Pediatric submersion has distinct demographic and seasonal patterns.
- Early physiological signs and specific scoring system values are key predictors of survival and neurological outcome.
Abstract:
The case histories of 47 consecutive pediatric submersion victims admitted to the Changhua Christian Hospital from 1983 to 1990 were retrospectively reviewed for patient status on arrival and eventual outcome. Age, sex, season, location, estimated submersion time, cardiopulmonary resuscitation (CPR) at the scene, vital signs on arrival, Orlowski score, modified physiologic stability index (PSI) scoring system were analyzed. Patient outcome, based on the status at discharge, was categorized as (1) 22 patients survived intact, with normal findings on neurologic examination; (2) 10 patients had neurologic insults, with abnormal neurologic findings including mental retardation; (3) 15 patients died. The results clearly demonstrated that there were no differences among these three groups in the variables of estimated submersion time, CPR at the scene, referral from local medical clinics. The prominent characteristics of pediatric submersion were male (74%), age below three years (64%), summer season (45%) and fishpool (60%). The favorable prognostic factors were a body temperature greater than thirty-five centigrade, detectable heart beat and respiration on arrival, Orlowski score below two and PSI below seven.