Portal de Periódicos da CAPES

Demographic Factors and Their Association with Outcomes in Pediatric Submersion Injury

2006; Wiley; Volume: 13; Issue: 3 Linguagem: Inglês

10.1111/j.1553-2712.2006.tb01698.x

1553-2712

Lois K. Lee, Cheng Mao, Kimberly M. Thompson,

Traffic and Road Safety

Academic Emergency MedicineVolume 13, Issue 3 p. 308-313 Free Access Demographic Factors and Their Association with Outcomes in Pediatric Submersion Injury Lois K. Lee MD, MPH, Corresponding Author Lois K. Lee MD, MPH Department of Medicine, Division of Emergency Medicine, Children's Hospital, Boston, Boston, MA*Division of Emergency Medicine, Children's Hospital, Boston, 300 Longwood Avenue, Boston, MA 02115. Fax: 617-730-0335; e-mail: lois.lee@childrens.harvard.eduSearch for more papers by this authorCheng Mao MD, ScD, Cheng Mao MD, ScD Center for Health Information, Statistics, Research, and Evaluation, Massachusetts Department of Public Health, Boston, MASearch for more papers by this authorKimberly M. Thompson ScD, Kimberly M. Thompson ScD Department of Medicine, Division of Adolescent Medicine, Children's Hospital, Boston, Boston, MA Department of Health Policy and Management, Harvard School of Public Health, Boston, MASearch for more papers by this author Lois K. Lee MD, MPH, Corresponding Author Lois K. Lee MD, MPH Department of Medicine, Division of Emergency Medicine, Children's Hospital, Boston, Boston, MA*Division of Emergency Medicine, Children's Hospital, Boston, 300 Longwood Avenue, Boston, MA 02115. Fax: 617-730-0335; e-mail: lois.lee@childrens.harvard.eduSearch for more papers by this authorCheng Mao MD, ScD, Cheng Mao MD, ScD Center for Health Information, Statistics, Research, and Evaluation, Massachusetts Department of Public Health, Boston, MASearch for more papers by this authorKimberly M. Thompson ScD, Kimberly M. Thompson ScD Department of Medicine, Division of Adolescent Medicine, Children's Hospital, Boston, Boston, MA Department of Health Policy and Management, Harvard School of Public Health, Boston, MASearch for more papers by this author First published: 28 June 2008 https://doi.org/10.1197/j.aem.2005.10.012Citations: 13AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Abstract Objectives: To describe the epidemiology and outcomes of serious pediatric submersion injuries and to identify factors associated with an increased risk of death or chronic disability. Methods: A retrospective database review of 1994–2000 Massachusetts death and hospital discharge data characterized demographic factors; International Classification of Diseases, Ninth Revision (ICD-9), Clinical Modification (ICD-9-CM), or ICD-10 injury codes; and outcomes for state residents 0–19 years of age identified with unintentional submersion injuries. The authors performed logistic regression analysis to correlate outcomes with risk and demographic factors. Results: The database included 267 cases of serious submersion injury, defined as those requiring hospitalization or leading to death. Of these 267 patients, 125 (47%) drowned, 118 (44%) were discharged home, 13 (5%) were discharged home with intravenous therapy or with availability of a home health aide, and 11 (4%) were discharged to an intermediate care/chronic care facility. The authors observed a trend of improved outcome in successively younger age groups (p < 0.0001). The multivariable logistic regression analysis showed an increased likelihood of poor outcome for males compared with females (odds ratio [OR]: 2.52; 95% confidence interval [95% CI] = 1.31 to 4.84) and for African Americans compared with whites (OR: 3.47; 95% CI = 1.24 to 9.75), and a decreased likelihood of poor outcome for Hispanics compared with whites (OR: 0.056; 95% CI = 0.013 to 0.24). Conclusions: After serious pediatric submersion injuries, the overall outcome appears largely bimodal, with children primarily discharged home or dying. The observations that better outcomes occurred among younger age groups, females, and Hispanic children, with worse outcomes in African American children, suggest that injury prevention for submersion injuries should consider differences in age, gender, and race/ethnicity. References Centers for Disease Control and Prevention. Available at: http:www.cdc.govncipcwisqars. Accessed Mar 8, 2004. Massachusetts Department of Public Health Injuries to Massachusetts Residents 1995–1999.. Boston , MA : Massachusetts Department of Health, April 2003. Wintemute GJ. Childhood drowning and near-drowning in the United States. Am J Dis Child. 1990; 144: 663– 9. Ellis AA, Trent RB. Hospitalizations for near drowning in California: incidence and costs. Am J Public Health. 1995; 85: 1115– 8. Sachdeva RC. Near drowning. Crit Care Clin. 1999; 15: 281– 96. Quan L. Near-drowning. Pediatr Rev. 1999; 20: 255– 9. Frates RC. Analysis of predictive factors in the assessment of warm-water near-drowning in children. Am J Dis Child. 1981; 135: 1006– 8. Graf WD, Cummings P, Quan L, Brutocao D. Predicting outcome in pediatric submersion victims. Ann Emerg Med. 1995; 26: 312– 9. Habib DM, Tecklenburg FW, Webb SA, Anas NG, Perkin RM. Prediction of childhood drowning and near-drowning morbidity and mortality. Pediatr Emerg Care. 1996; 12: 255– 8. Suominen P, Baillie C, KIorpela R, Rautanen S, Ranta S, Olkkola KT. Impact of age, submersion time and water temperature on outcome in near-drowning. Resuscitation. 2002; 52: 247– 54. Quan L, Wentz KR, Gore EJ, Copass MK. Outcome and predictors of outcome in pediatric submersion victims receiving prehospital care in King County, Washington. Pediatrics. 1990; 86: 586– 93. Quan L, Kinder D. Pediatric submersions: prehospital predictors of outcome. Pediatrics. 1992; 90: 909– 13. Orlowski JP. Prognostic factors in pediatric cases of drowning and near-drowning. J Am Coll Emerg Physicians. 1979; 8: 176– 9. Joseph MM, King WD. Epidemiology of hospitalization for near-drowning. South Med J. 1998; 91: 253– 5. Warneke CL, Cooper SP. Child and adolescent drowning in Harris County, Texas, 1983–1990. Am J Public Health. 1994; 84: 593– 8. Wintemute GJ, Kraus JF, Teret S, Wright M. Drowning in childhood and adolescence: a population-based study. Am J Public Health. 1987; 77: 830– 2. International Classification of Diseases, 9th Revision (ICD-9). Geneva : World Health Organization. International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM). Geneva : World Health Organization. International Classification of Diseases, 10th Revision (ICD-10). Geneva : World Health Organization. Kaiser FamilyFoundation. State Health Facts Online. Available at: http:www.statehealthfacts.kff.org. Accessed Feb 4, 2004. Quan L, Gore EJ, Wentz K, Allen J, Novack AH. Ten-year study of pediatric drownings and near-drowning in King County, Washington: lessons in injury prevention. Pediatrics. 1989; 83: 1035– 40. Christensen DW, Jansen P Perkin RM. Outcome and acute care hospital costs after warm water near drowning in children. Pediatrics. 1997; 99: 715– 21. Kyriacou DN, Arcinue EL, Peek C, Kraus JF. Effect of immediate resuscitation on children with submersion injury. Pediatrics. 1994; 84: 137– 42. Zuckerman GB, Conway EE. Drowning and near drowning: a pediatric epidemic. Pediatr Ann. 2000; 29: 360– 6. Brenner RA, Trumble AC, Smith GS, Kessler EP, Overpeck MD. Where children drown, United States, 1995. Pediatrics. 2001; 108: 85– 9. Brenner RA, Smith GS Overpeck MD. Divergent trends in childhood drowning rates. JAMA. 1994; 271: 1606– 8. Citing Literature Volume13, Issue3March 2006Pages 308-313 ReferencesRelatedInformation