Prognostic factors and outcome after drowning in an adult population.
BACKGROUND
Drowning remains an actual problem. Although medical assistance has improved, it still has high rates of morbidity and mortality. We set out to explore the clinical characteristics and outcome of drowning patients admitted to the intensive care unit (ICU) of tertiary-care university hospital.


METHODS
We designed a retrospective observational study to analyse all drowning patients admitted to our ICU after successful cardiopulmonary resuscitation. The study was conducted during 1 January 1992-31 December 2005. There was no exclusion. We used a univariate analysis to evaluate the effect on patient and management characteristics on survival.


RESULTS
There were 43 patients (five children and 38 adults), with male predominance. Fifteen patients, all adults (34.9%), died. Submersion time, age, Glasgow Coma Score (GCS), pupillary reactivity and acute physiology and chronic health evaluation (APACHE II) at ICU admission were related to mortality. Non-survivors presented a higher glycaemia level at ICU admission than survivors (P=0.005).


CONCLUSIONS
The outcome is closely related to the patient's clinical status on arrival to the hospital. We have found that submersion time, age, GCS, pupillary reactivity and APACHE II at ICU admission were related to mortality. Further research in prospective studies is needed.
Ballesteros
M A
MA
Critical Care Medicine, Servicio de Medicina Intensiva, Santander, Spain. gelesballesteros@yahoo.com
Gutiérrez-Cuadra
M
M
Muñoz
P
P
Miñambres
E
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000209:etiology; D016887:Cardiopulmonary Resuscitation; D002648:Child; D003422:Critical Care; D005260:Female; D015600:Glasgow Coma Scale; D023261:Glasgow Outcome Scale; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015701:Near Drowning / Q000453:epidemiology / Q000628:therapy*; D011379:Prognosis; D016896:Treatment Outcome; D055815:Young Adult