@article{ref1,
title="Failure of aggressive therapy to alter outcome in pediatric near-drowning",
journal="Pediatric emergency care",
year="1997",
author="Spack, L. and Gedeit, R. and Splaingard, M. and Havens, P. L.",
volume="13",
number="2",
pages="98-102",
abstract="OBJECTIVES: To identify predictors of outcome in pediatric near-drowning victims, and to measure the effectiveness of therapy in pediatric near-drowning victims by assessing clinical outcome as a function of injury severity at presentation and therapeutic interventions during hospitalization. DESIGN: Retrospective chart review at a tertiary care university associated Children's Hospital from January 1976 to July 1992. MEASUREMENTS AND MAIN RESULTS: Initial intensive care unit (ICU) assessment included a Glasgow Coma Score (GCS) and a Pediatric Risk of Mortality (PRISM) Score. Outcome was assessed using a standard scoring system classifying functional abilities at hospital discharge as no functional disability, independent, partially independent, or total dependence on caregivers for function. Forty (49%) of 81 died. Of the survivors, 26 (63%) had no functional disability or were partially dependent at hospital discharge. Of the 47 (64%) patients with a GCS < or = 4 on presentation to the ICU, 37 (79%) died and 10 (21%) were dependent in all areas of function at discharge. Of the 40 (60%) patients who had a PRISM score < 20, 98% either died or were completely dependent at discharge. Of the 49 patients who were asystolic upon arrival to the emergency department (ED), 76% died, and the rest were completely dependent. Logistic regression showed that therapy had no independent effect on outcome when disease severity was accounted for. CONCLUSIONS: Severity of illness measured by GCS and PRISM score in the ICU can be useful in predicting outcome. For patients cared for in a Pediatric Intensive Care Unit, those with asystole on arrival at the ED had uniformly poor outcome. Currently available therapies do not alter outcome.<p /><p>Language: en</p>",
language="en",
issn="0749-5161",
doi="",
url="http://dx.doi.org/"
}