Breindahl Niklas, Wolthers Signe A, Jensen Theo W, Holgersen Mathias G, Blomberg Stig N F, Steinmetz Jacob, Christensen Helle C
Prehospital Center Region Zealand, Ringstedgade 61, 13., 4700 Næstved, Denmark; Department of Neonatal and Pediatric Intensive Care, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Prehospital Center Region Zealand, Ringstedgade 61, 13., 4700 Næstved, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Am J Emerg Med. 2023 Nov;73:55-62. doi: 10.1016/j.ajem.2023.08.024. Epub 2023 Aug 15.
Accurate, reliable, and sufficient data is required to reduce the burden of drowning by targeting preventive measures and improving treatment. Today's drowning statistics are informed by various methods sometimes based on data sources with questionable reliability. These methods are likely responsible for a systematic and significant underreporting of drowning. This study's aim was to assess the 30-day survival of patients with out-of-hospital cardiac arrest (OHCA) identified in the Danish Cardiac Arrest Registry (DCAR) after applying the Danish Drowning Formula.
This nationwide, cohort, registry-based study with 30-day follow-up used the Danish Drowning Formula to identify drowning-related OHCA with a resuscitation attempt from the DCAR from January 1st, 2016, through December 31st, 2021. The Danish Drowning Formula is a text-search algorithm constructed for this study based on trigger-words identified from the prehospital medical records of validated drowning cases. The primary outcome was 30-day survival from OHCA. Data were analyzed using multiple logistic regression.
Drowning-related OHCA occurred in 374 (1%) patients registered in the DCAR compared to 29,882 patients with OHCA from other causes. Drowning-related OHCA more frequently occurred at a public location (87% vs 25%, p < 0.001) and were more frequently witnessed by bystanders (80% vs 55%, p < 0.001). Both 30-day and 1-year survival for patients with drowning-related OHCA were significantly higher compared to OHCA from other causes (33% vs 14% and 32% vs 13%, respectively, p < 0.001). The adjusted odds ratio for 30-day survival for drowning-related OHCA and other causes of OHCA was 2.3 [1.7-3.2], p < 0.001. Increased 30-day survival was observed for drowning-related OHCA occurring at swimming pools compared to public location OHCA from other causes with an OR of 11.6 [6.0-22.6], p < 0.001.
This study found higher 30-day survival among drowning-related OHCA compared to OHCA from other causes. This study proposed that a text-search algorithm (Danish Drowning Formula) could explore unstructured text fields to identify drowning persons. This method may present a low-resource solution to inform the drowning statistics in the future.
This study was registered at ClinicalTrials.gov before analyses (NCT05323097).
为了通过采取预防措施和改善治疗来减轻溺水负担，需要准确、可靠且充分的数据。如今的溺水统计数据是通过各种方法得出的，这些方法有时基于可靠性存疑的数据源。这些方法可能导致溺水事件系统性地严重漏报。本研究的目的是评估在应用丹麦溺水公式后，丹麦心脏骤停登记处（DCAR）中确定的院外心脏骤停（OHCA）患者的30天生存率。
这项全国性的队列研究基于登记处，随访30天，使用丹麦溺水公式从DCAR中识别2016年1月1日至2021年12月31日期间有复苏尝试的与溺水相关的OHCA。丹麦溺水公式是一种文本搜索算法，是基于从经证实的溺水病例的院前医疗记录中识别出的触发词为本研究构建的。主要结局是OHCA后的30天生存率。数据采用多元逻辑回归分析。
在DCAR登记的患者中，374例（1%）发生了与溺水相关的OHCA，而其他原因导致OHCA的患者有29,882例。与溺水相关的OHCA更常发生在公共场所（87%对25%，p<0.001），并且更常被旁观者目击（80%对55%，p<0.001）。与其他原因导致的OHCA相比，与溺水相关的OHCA患者的30天和1年生存率均显著更高（分别为33%对14%和32%对13%，p<0.001）。与溺水相关的OHCA和其他原因导致的OHCA的30天生存调整比值比为2.3[1.7 - 3.2]，p<0.001。与其他原因在公共场所发生的OHCA相比，游泳池发生的与溺水相关的OHCA的30天生存率增加，比值比为11.6[6.0 - 22.6]，p<0.001。
本研究发现，与其他原因导致的OHCA相比，与溺水相关的OHCA患者的30天生存率更高。本研究提出，一种文本搜索算法（丹麦溺水公式）可以探索非结构化文本字段来识别溺水者。这种方法可能为未来的溺水统计提供一种低资源解决方案。
本研究在分析前已在ClinicalTrials.gov注册（NCT05323097）。
