Abbe Marisa, Rix Kevin, Aguilar David, Alderete Jesus, Fernandez Alejandra, Messiah Sarah
Injury Prevention, Children's Medical Center, Dallas, Dallas, Texas, USA
Department of Surgery, UT Southwestern Medical Center, Dallas, Texas, USA.
Inj Prev. 2024 Jul 24. doi: 10.1136/ip-2024-045296.
Drowning is a leading cause of death for young children and knowing what puts a child at risk helps efforts across the spectrum of prevention. The purpose of this study was to identify risk and protective factors associated with hospital admission and mortality following paediatric drowning from a large level-1 paediatric trauma centre.
Children (ages 0-17) who presented at an emergency department or were admitted for a drowning event between 2017 and 2023 were included in this retrospective cohort study (n=698). This study examined differences between patients who were admitted compared with not admitted, and those who survived compared with those who did not survive.
Participants who had adult supervision at the time of their drowning were significantly less likely to be admitted (OR=0.31, 95% CI 0.22 to 0.43, p<0.001) and significantly more likely to survive (OR=6.9, 95% CI 3.2 to 15.4, p<0.001). The environment also played a significant role in drowning outcomes. Children who drowned in a pool compared with other bodies of water were significantly more likely to survive (OR=3.0, 95% CI 1.6 to 5.5, p<0.001). Children from communities with higher child opportunity compared with those from very low opportunity were both simultaneously more likely to be admitted (IRR=1.7-2.4, 95% CI 1.3 to 3.3, p<0.001) and more often survived (IRR=1.7-3.0, 95% CI 1.3 to 3.5, p<0.001).
Our analysis revealed significant differences in drowning risk related to adult supervision, location of drowning and where a child lives. These findings can help drowning prevention strategies mitigate the severity of drowning by enhancing educational messages, resources and policy.
溺水是幼儿死亡的主要原因,了解哪些因素会使儿童面临溺水风险有助于全面开展预防工作。本研究的目的是从一家大型一级儿科创伤中心确定与小儿溺水后住院和死亡相关的风险因素及保护因素。
本回顾性队列研究纳入了2017年至2023年间在急诊科就诊或因溺水事件入院的儿童(0至17岁)(n = 698)。本研究比较了入院患者与未入院患者之间以及存活患者与未存活患者之间的差异。
溺水时有成人监护的参与者入院的可能性显著降低(OR = 0.31,95% CI 0.22至0.43,p < 0.001),存活的可能性显著增加(OR = 6.9,95% CI 3.2至15.4,p < 0.001)。环境在溺水结果中也起着重要作用。与在其他水体中溺水的儿童相比,在游泳池中溺水的儿童存活的可能性显著更高(OR = 3.0,95% CI 1.6至5.5,p < 0.001)。与来自机会极低社区的儿童相比,来自儿童机会较高社区的儿童入院的可能性同时更高(IRR = 1.7 - 2.4,95% CI 1.3至3.3,p < 0.001),存活的可能性也更高(IRR = 1.7 - 3.0,95% CI 1.3至3.5,p < 0.001)。
我们的分析揭示了与成人监护、溺水地点和儿童居住地点相关的溺水风险存在显著差异。这些发现有助于溺水预防策略通过加强教育信息、资源和政策来减轻溺水的严重程度。