Pediatric drowning hospitalizations at the only pediatric intensive care unit center in Okinawa: a retrospective...

This exploratory study aimed to describe characteristics associated with pediatric drowning and to examine the socioeconomic context, rather than to establish socioeconomic effects, by conducting a retrospective analysis at the sole tertiary facility with a pediatric intensive care unit in Okinawa Prefecture, Japan.

Information from electronic medical records was collated for 75 drowning-related hospitalizations involving individuals aged less than 20 years at the Okinawa Prefectural Nanbu Medical Center and Children's Medical Center from April 1, 2006, to May 31, 2021. Data on patient gender, drowning or hospitalization duration, drowning timing and settings, pre-existing medical conditions, and zip code were extracted from electronic medical records.

Among the 75 hospitalized patients, 64 were discharged without any morbidity, whereas 11 either perished or sustained severe morbidity. The submersion time (2.9 min, standard deviation [SD]: 4.6, in the no morbidity group vs. 44.1 min, SD: 87.0 in the severe group) and length of stay (4.1 days, SD: 3.7 vs. 46.4 days, SD: 64.9, respectively) were markedly extended in the severe group. Additionally, in patients under four years of age, drownings frequently occurred in bathrooms (p = 0.008), with incidents predominantly taking place between 17:00 and 23:00 (p = 0.021). Among hospitalized pediatric drowning patients, supervision was associated with lower odds of severe morbidity (odds ratio 0.17 (95% confidence interval 0.03-0.81)). This association persisted after adjustment for potential confounders such as the Area Deprivation Index and time of day. The interaction between supervision and the Area Deprivation Index was of borderline statistical significance (p = 0.050) and is considered hypothesis-generating.

Within this cohort of hospitalized pediatric drowning patients, the presence of supervision was associated with less severe outcomes. These exploratory findings highlight the potential value of preventive strategies tailored to regional attributes, but do not establish socioeconomic or causal effects.