Citation

Cai M, Lee PP, Chong PL, Peh FTT, Mathur S. Ann. Acad. Med. Singapore 2023; 52(9): 488-490.

Copyright

(Copyright © 2023, Academy of Medicine, Singapore)

DOI

10.47102/annals-acadmedsg.2022385

PMID

unavailable

Abstract

According to the latest Utstein-style consensus, drowning is defined as the primary respiratory impairment resulting from submersion or immersion in a liquid medium.1 Patients may experience hypothermia, acute respiratory distress syndrome and shock.1 The pathophysiology is poorly understood, but could relate to physiological responses to temperature, water swallowing and electrolyte disturbances.2 Globally, more than 500,000 deaths from drowning are reported every year.3 Poor prognostic factors include low Glasgow Coma Scale (GCS) score and cardiorespiratory arrest. Treatment is largely supportive. Most preventative measures are centred on aquatic safety education and swimming lessons. Based on the National Sport Participation Survey 2018–2022, swimming has consistently ranked among the 5 most popular sports in Singapore.4 This study aimed to describe the outcomes of patients admitted for drowning.

All patients admitted to a tertiary hospital for drowning between January 2011 and December 2021 were identified from a prospectively maintained institutional database and included in this study. Relevant clinical data pertaining to the pre-hospital, emergency department (ED), inpatient and discharge care were anonymised and extracted. The primary outcome measured was in-hospital mortality and the secondary outcome measured was hospital length of stay (LOS). Statistical analysis was performed using R version 4.0.5 (R Core Team 2020, Vienna, Austria). Univariate and multivariate logistic regression analyses were performed to evaluate potentially prognostic risk factors. The odds ratio (OR) and corresponding 95% confidence intervals were calculated and P<0.05 was deemed statistically significant.

A total of 56 patients were included. All patients had signs of life in the ED. The majority were male (73.2%), under 40 years of age (57.1%) and had GCS scores more than 12 (64.3%). Most drowning incidents occurred at the open sea (41.1%) and private pools (37.5%); 14 patients (25%) consumed alcohol and the majority of these patients were male (78.6%). None of the patients consumed psychoactive drugs. Occupational accidents and suicide attempts were uncommon, with only 2 (3.6%) and 4 (7.1%) occurrences, respectively. There was equal sex distribution for suicide attempts.

Language: en