Drowning Among Tunisian Children: Clinical Patterns and Outcomes

Describe clinical and therapeutic aspects of pediatric drowning and analyse predictive factors of mortality.

We conducted a retrospective analysis of patients under 16 years of age admitted between 2018 and 2022 to the Pediatric Intensive Care Unit at Farhat Hached University Hospital.

Our study included 64 patients. The sex ratio was 1.46. The mean age was 7.1 ± 4.3 years. Most drowning occurred during the summer (92.2%), in seawater (76.6%). The mean estimated immersion time was 4 ± 5.8 minutes. The majority of these drownings (70.3%) were severe (stage 3, 4, 5, or 6). The most frequent clinical signs were: tachypnea (93.8%), auscultation abnormalities (93.8%), oxygen saturation < 92% (73.4%), and tachycardia (71.9%). Chest X-ray was abnormal in 75% of cases. Mechanical ventilation was indicated in 14.1% of cases. Vasopressor drugs were used in 12.5% of cases. Antibiotic therapy was initiated in 70.3% of patients. The mortality rate was 10.9%. In multivariate analysis, predictive factors for mortality were: a Szpilman stage equal to 6 (p <0.005), a Glasgow score < 8 (p <0.005), pupillary abnormalities (p <0.005), hypothermia < 35 (p<0.005), hepatic cytolysis (p = 0.02), and blood pH < 7.1 (p <0.005).

Drowning is a fatal, yet preventable global public health problem, particularly touching children and young adults. Mortality depends on several epidemiological, clinical and biological factors.