Review of 14 drowning publications based on the Utstein style for drowning

Abstract

BackgroundThe Utstein style for drowning (USFD) was published in 2003 with the aim of improving drowning research. To support a revision of the USFD, the current study aimed to generate an inventory of the use of the USFD parameters and compare the findings of the publications that have used the USFD.MethodsA search in Pubmed, Embase, the Cochrane Library, Web of Science and Scopus was performed to identify studies that used the USFD and were published between 01-10-2003 and 22-03-2015. We also searched in Pubmed, Embase, the Cochrane Library, Web of Science, and Scopus for all publications that cited the two publications containing the original ILCOR advisory statement introducing and recommending the USFD. In total we identified 14 publications by groups that explicitly used elements of the USFD for collecting and reporting their data.ResultsOf the 22 core and 19 supplemental USFD parameters, 6–19 core (27–86%) and 1–12 (5–63%) supplemental parameters were used; two parameters (5%) have not been used in any publication. Associations with outcome were reported for nine core (41%) and five supplemental (26%) USFD parameters. The USFD publications also identified non-USFD parameters related to outcome: initial cardiac rhythm, time points and intervals during resuscitation, intubation at the drowning scene, first hospital core temperature, serum glucose and potassium, the use of inotropic/vasoactive agents and the Paediatric Index of Mortality 2-score.ConclusionsFourteen USFD based drowning publications have been identified. These publications provide valuable information about the process and quality of drowning resuscitation and confirm that the USFD is helpful for a structured comparison of the outcome of drowning resuscitation.

Fatal drowning statistics from the Netherlands – an example of an aggregated demographic profile

“…Also, data on non-fatal drowning victims recorded by aquatic rescue organisations and patients admitted to emergency departments and intensive care units will enhance the perspective on the issue [ 3 , 46 , 129 – 131 ]. Although categorisation systems for clinical studies are available which report fatal and non-fatal drowning data in a standardised way, these systems are not suitable for demographic or epidemiological studies [ 4 , 127 , 132 , 133 ].…”

Addressing gaps in our understanding of the drowning patient: a protocol for the retrospective development of an Utstein style database and multicentre collaboration

“…Articles using the USFD have reported against different variables, with some variables such oxygen haemoglobin saturation, presence of cyanosis and time of victim rescue being rarely used. 5 Although the USFD has been revised to more accurately reflect the data that can be collected, to date no study has investigated whether the lack of use of variables is due to investigator choice or unavailability of the data. We intend to investigate and report on the availability of USFD variables in the healthcare system in Queensland, Australia.…”

“…4 However, its uptake in drowningrelated studies has been limited, with just over one published article a year reporting its use. 5 Possible explanations for this include the large number (76) of variables included in the USFD, outlined in table 1. There are 49 core variables and 27 supplementary variables (4).…”

“…A uniform dataset for the purposes of ensuring consistency in the reporting of drowning-related studies, the Utstein style for drowning (USFD), was published in 20033 and updated in 2015 4. However, its uptake in drowning-related studies has been limited, with just over one published article a year reporting its use 5. Possible explanations for this include the large number (76) of variables included in the USFD, outlined in table 1.…”

“…However, to collect all the variables there is a requirement to extrapolate data from multiple sources, such as lifeguard services, emergency medical service (EMS), emergency department (ED), inpatient unit (IPU) and intensive care unit (ICU) patient documentation, as well as radiology and pathology reporting systems. Articles using the USFD have reported against different variables, with some variables such oxygen haemoglobin saturation, presence of cyanosis and time of victim rescue being rarely used 5. Although the USFD has been revised to more accurately reflect the data that can be collected, to date no study has investigated whether the lack of use of variables is due to investigator choice or unavailability of the data.…”