Development and validation of a clinico-biological score to predict outcomes in patients with drowning-associated...

Area of Science:

• Emergency Medicine
• Cardiology
• Toxicology

Background:

• No dedicated prognostic tool exists for drowning-associated cardiac arrest (DACA) patients.
• Existing scoring systems are designed for general out-of-hospital cardiac arrest, not specifically for drowning incidents.

Purpose of the Study:

• To develop and validate a prognostic score for predicting day-28 mortality in DACA patients.
• To identify early risk factors associated with mortality in DACA patients.

Main Methods:

• Retrospective analysis of two multicenter cohorts of drowning patients.
• Logistic regression used to identify risk factors for day-28 mortality in the development cohort.
• A DACA prediction score was developed and validated on a separate cohort.

Main Results:

• Identified risk factors for mortality: CPR duration >20 min, temperature <34°C, need for mechanical ventilation, and lactate >7 mmol/L.
• The DACA score achieved an AUC of 0.91 in the development cohort and 0.82 in the validation cohort.
• A score ≥4 indicated significantly lower day-28 survival, with high sensitivity and specificity.

Conclusions:

• The developed DACA score effectively predicts day-28 mortality in drowning patients.
• A DACA score of 4 or higher is associated with a significantly reduced likelihood of survival.
• Prospective validation and assessment of the DACA score's clinical utility are recommended.