The epidemiology of drowning among Saudi children: results from a large trauma center

Abstract

BACKGROUND: Drowning is the third leading cause of unintentional death among children worldwide. Although natural waters pose a risk of drowning in low-income countries, swimming pools are more prevalent in high-income countries. In Saudi Arabia, injuries and drowning are a significant threat to population health. Local data is limited, which affects an understanding of the extent of the burden and the development of prevention strategies. OBJECTIVE: Determine the epidemiological characteristics, risk factors, and clinical outcomes of drowning among children. DESIGN: Retrospective chart review. SETTING: Patients admitted to the tertiary care unit of a hospital in Riyadh. PATIENTS AND METHODS: Data was collected on children who drowned (age 0-14) between January 2015 and August 2020. Cases were identified from the electronic health record system where the diagnosis was drowning. Differences in characteristics and outcomes between nonfatal cases with no neurological damage and fatal cases with neurological damage were analyzed. MAIN OUTCOME MEASURE: Drowning mortality and morbidity. SAMPLE SIZE: 99. RESULTS: Of the 99 drowning cases, 22 (22.2%) had a fatal outcome or resulted in neurological damage. The most-reported drowning site was private pools (82%). The majority of cases involved children younger than the age of two (54%). Eighty-four cases (84.8%) occurred on holidays. Cardiopulmonary resuscitation was performed in 61 (61.6%) of cases. A significant association was found between the delay in initiating resuscitation and an unfavorable outcome ( P <.01). A high Glasgow Coma Scale score upon admission was a predictor of normal recovery ( P <.01). CONCLUSION: These findings warrant investment to increase public awareness of the risks of leaving children unsupervised in swimming pools. In addition, there is a need to ensure early resuscitation of drowning victims by promoting life support courses in order to facilitate positive outcomes. LIMITATIONS: The study was conducted in one tertiary center located in a non-coastal city so the results may not be generalizable. CONFLICT OF INTEREST: None.

Drowning in the Eastern Mediterranean region: a systematic literature review of the epidemiology, risk factors and strategies for prevention

“…Data on non-fatal drowning were limited. Several studies identified the significant non-fatal drowning burden among young children less than five [ 32 , 51 , 67 ]. By contrast, a study from Saudi Arabia reported almost half (43.1%) of all non-fatal drowning cases in children 1–14, occurring among school age children (7–14 years of age) [ 64 ].…”

“…While males typically report significantly higher fatal drowning rates, among the non-fatal cases reported, the sex split was proportionately more similar. A study of non-fatal drowning among children 0–14 years of age in Saudi Arabia identified 40% of cases were of girls [ 32 ]. Among the all-age population, a study from northern Iran highlighted females accounted for 20.2% of all non-fatal drownings from 2007 to 2008 [ 42 ].…”

“…There were several factors identified in the literature as being protective for drowning outcome. These were a high GCS score upon admission and upon end of care [ 32 ], decreased length of hospital stay [ 32 ], shorter length of time submersed [ 32 ] and a body temperature of ≥36 degrees [ 51 ] (Table 3 ).…”

Analysis of Climate and Income-Related Factors for High Regional Child Drowning Mortality in China

“…Drowning is a leading cause of death in young people, especially in low- and middle-income countries [ 1 ]. Current studies on drowning have concentrated on epidemiological characteristics (e.g., age, sex, and position) [ 2 – 4 ], clinical treatment [ 5 ], and social risk factors (e.g., poverty, parental education, full-time or part-time care status, safety education, etc.) [ 6 , 7 ].…”

Relationship Between Climatic Factors and Regional Drowning Mortality in China

“…Current studies on drowning are concentrated in epidemiological characteristic (i.e. age, sex, position) (Wang, et al, 2017;Claesson, et al, 2021;Alkhalaf, et al, 2021), clinical treatment (Roberts, et al, 2021) (2) Monthly mortality data of young people in China.…”