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沙特儿童溺水的流行病学:大型创伤中心的研究结果。

The epidemiology of drowning among Saudi children: results from a large trauma center.

机构信息

From the Department of Pediatrics, King Abdulaziz Medical City, Riyadh, Saudi Arabia.

From the College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.

出版信息

Ann Saudi Med. 2021 May-Jun;41(3):157-164. doi: 10.5144/0256-4947.2021.157. Epub 2021 Jun 1.

Abstract

BACKGROUND

Drowning is the third leading cause of unintentional death among children worldwide. Although natural waters pose a risk of drowning in low-income countries, swimming pools are more prevalent in high-income countries. In Saudi Arabia, injuries and drowning are a significant threat to population health. Local data is limited, which affects an understanding of the extent of the burden and the development of prevention strategies.

OBJECTIVE

Determine the epidemiological characteristics, risk factors, and clinical outcomes of drowning among children.

DESIGN

Retrospective chart review.

SETTING

Patients admitted to the tertiary care unit of a hospital in Riyadh.

PATIENTS AND METHODS

Data was collected on children who drowned (age 0-14) between January 2015 and August 2020. Cases were identified from the electronic health record system where the diagnosis was drowning. Differences in characteristics and outcomes between nonfatal cases with no neurological damage and fatal cases with neurological damage were analyzed.

MAIN OUTCOME MEASURE

Drowning mortality and morbidity.

SAMPLE SIZE

RESULTS

Of the 99 drowning cases, 22 (22.2%) had a fatal outcome or resulted in neurological damage. The most-reported drowning site was private pools (82%). The majority of cases involved children younger than the age of two (54%). Eighty-four cases (84.8%) occurred on holidays. Cardiopulmonary resuscitation was performed in 61 (61.6%) of cases. A significant association was found between the delay in initiating resuscitation and an unfavorable outcome (<.01). A high Glasgow Coma Scale score upon admission was a predictor of normal recovery (<.01).

CONCLUSION

These findings warrant investment to increase public awareness of the risks of leaving children unsupervised in swimming pools. In addition, there is a need to ensure early resuscitation of drowning victims by promoting life support courses in order to facilitate positive outcomes.

LIMITATIONS

The study was conducted in one tertiary center located in a non-coastal city so the results may not be generalizable.

CONFLICT OF INTEREST

None.

摘要

背景

溺水是全球儿童意外伤害死亡的第三大原因。尽管自然水域是低收入国家溺水的风险因素,但游泳池在高收入国家更为普遍。在沙特阿拉伯,伤害和溺水是对人口健康的重大威胁。当地数据有限,这影响了对负担程度的理解和预防策略的制定。

目的

确定儿童溺水的流行病学特征、危险因素和临床结局。

设计

回顾性病历审查。

地点

利雅得一家医院的三级护理病房。

患者和方法

收集了 2015 年 1 月至 2020 年 8 月期间溺水(年龄 0-14 岁)的儿童数据。通过电子病历系统确定病例,该系统的诊断为溺水。对无神经损伤的非致命病例和有神经损伤的致命病例的特征和结局进行了分析。

主要观察指标

溺水死亡率和发病率。

样本量

99。

结果

在 99 例溺水病例中,有 22 例(22.2%)死亡或出现神经损伤。报告最多的溺水地点是私人游泳池(82%)。大多数病例涉及两岁以下儿童(54%)。84 例(84.8%)发生在节假日。61 例(61.6%)进行了心肺复苏。发现开始复苏的延迟与不良结局之间存在显著相关性(<.01)。入院时格拉斯哥昏迷量表评分高是正常恢复的预测因素(<.01)。

结论

这些发现表明需要投资提高公众对将儿童无人监督留在游泳池中存在风险的认识。此外,需要通过推广生命支持课程来确保溺水受害者尽早复苏,以促进积极的结局。

局限性

该研究在一个位于非沿海城市的三级中心进行,因此结果可能不具有普遍性。

利益冲突

无。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/069f/8176376/82ef8880348b/0256-4947.2021.157-fig1.jpg

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