Abstract：
BACKGROUND: 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.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: 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.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: 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.
摘要：
背景：溺水是幼儿死亡的主要原因，了解是什么使儿童处于危险之中有助于整个预防领域的努力。这项研究的目的是确定与大型1级儿科创伤中心的儿科溺水后住院和死亡率相关的风险和保护因素。
方法：这项回顾性队列研究包括在2017年至2023年期间在急诊科就诊或因溺水事件入院的儿童（0-17岁）（n=698）。这项研究检查了入院患者与未入院患者之间的差异，和那些幸存下来的人与那些没有幸存下来的人相比。
结果：在溺水时接受成人监督的参与者入院的可能性明显较低（OR=0.31，95％CI0.22至0.43，p<0.001），并且更有可能生存（OR=6.9，95％CI3.2至15.4，p<0.001）。环境在溺水结果中也发挥了重要作用。与其他水体相比，溺水在游泳池中的儿童更有可能存活（OR=3.0，95％CI1.6至5.5，p<0.001）。来自儿童机会较高的社区的儿童与来自非常低的机会的儿童相比，同时更有可能被接纳（IRR=1.7-2.4，95％CI1.3至3.3，p<0.001），并且更经常存活（IRR=1.7-3.0，95％CI1.3至3.5，p<0.001）。
结论：我们的分析显示，与成人监护相关的溺水风险存在显着差异，溺水的位置和孩子的住所。这些发现可以通过增强教育信息来帮助溺水预防策略减轻溺水的严重程度，资源和政策。
方法：这项回顾性队列研究包括在2017年至2023年期间在急诊科就诊或因溺水事件入院的儿童（0-17岁）（n=698）。这项研究检查了入院患者与未入院患者之间的差异，和那些幸存下来的人与那些没有幸存下来的人相比。
结果：在溺水时接受成人监督的参与者入院的可能性明显较低（OR=0.31，95％CI0.22至0.43，p<0.001），并且更有可能生存（OR=6.9，95％CI3.2至15.4，p<0.001）。环境在溺水结果中也发挥了重要作用。与其他水体相比，溺水在游泳池中的儿童更有可能存活（OR=3.0，95％CI1.6至5.5，p<0.001）。来自儿童机会较高的社区的儿童与来自非常低的机会的儿童相比，同时更有可能被接纳（IRR=1.7-2.4，95％CI1.3至3.3，p<0.001），并且更经常存活（IRR=1.7-3.0，95％CI1.3至3.5，p<0.001）。
结论：我们的分析显示，与成人监护相关的溺水风险存在显着差异，溺水的位置和孩子的住所。这些发现可以通过增强教育信息来帮助溺水预防策略减轻溺水的严重程度，资源和政策。
