PDF(Pubmed)
Abstract：
Fatal and nonfatal drowning are among the leading causes of death and lifelong severe neurological impairment among children and adolescents. This study aimed to complement research from Leipzig 1994-2008 to seek trends within risk factors, treatments, and outcomes throughout the last decade. We retrospectively investigated data of 47 inpatients aged 0-18 admitted to Leipzig University Department of Pediatrics who matched ICD-10 code T75.1 from 2008 to 2020 and compared them to a preceding study at the same institution. We also examined the prognostic value of parameters regarding the patients\' outcomes. There were three median incidents per annum. The median age was 2.75 years; 76% of incidents happened in males. An accumulation was seen during the summer months and weekends. Most drowning incidents occurred in private ponds or pools (48.9%). Thirty-nine children were discharged without resulting morbidity, four showed neurological impairment, and three died. Risk factors concerning age, sex, and incident characteristics were confirmed. Special supervision needs still apply to 1-3-year-old male children or children with pre-existing health conditions around private pools and ponds. Hospitalization duration shortened, and morbidity and lethality decreased since the previous study. There was structural improvement in primary care and medical documentation. Parameters suggesting good outcomes include a submersion time < 5 min, GCS > 3 points, spontaneous movement upon admission, remaining pupillary light response, the absence of cardiovascular arrest, body temperature ≥ 32 °C, pH > 7, blood glucose < 15 mmol/L, lactate < 14 mmol/L, base excess ≥ -15 mmol/L, and the absence of ARDS. Clear legislation can contribute to improved private home water safety. Further studies should include a broad in- and outpatient spectrum and standardized incident documentation presupposing Utstein-style reporting. Regular reinvestigation of consistent geographical regions facilitates process evaluations of drowning epidemiology and therapy evolution.
摘要：
致命性和非致命性溺水是儿童和青少年死亡和终身严重神经功能缺损的主要原因之一。本研究旨在补充莱比锡1994-2008年的研究，以寻求风险因素中的趋势，治疗,以及过去十年的成果。我们回顾性调查了2008年至2020年莱比锡大学儿科收治的47名0-18岁住院患者的数据，这些患者符合ICD-10代码T75.1，并将其与同一机构的先前研究进行了比较。我们还检查了有关患者预后的参数的预后价值。每年有三起中位数事件。平均年龄为2.75岁；76%的事件发生在男性身上。在夏季和周末看到了积累。大多数溺水事件发生在私人池塘或游泳池（48.9％）。39名儿童出院，没有发病，四个显示神经损伤，三人死亡。有关年龄的危险因素，性别,事件特征得到确认。特殊监督需求仍然适用于1-3岁的男性儿童或在私人游泳池和池塘周围已有健康状况的儿童。住院时间缩短，和发病率和致死率下降，因为以前的研究。初级保健和医疗文件的结构有所改善。表明良好结果的参数包括浸没时间<5分钟，GCS>3分,入院时自发运动，剩余的瞳孔光反应，没有心血管骤停，体温≥32°C，pH>7，血糖<15mmol/L，乳酸<14mmol/L，碱过量≥-15mmol/L，没有ARDS。明确的立法有助于改善私人家庭用水安全。进一步的研究应包括广泛的门诊和门诊范围以及以Utstein风格报告为前提的标准化事件文档。对一致的地理区域进行定期重新调查有助于对溺水流行病学和治疗进展进行过程评估。
