ArticleCritical care (London, England)2021
Clinical spectrum and risk factors for mortality among seawater and freshwater critically ill drowning patients: a French multicenter study.
Article in Critical care (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Pre-Existing Medical Conditions: A Systematic Literature Review of a Silent Contributor to Adult Drowning.International journal of environmental research and public health · 2022Pooled it
- Rescue strategies combining ultra-protective ventilation and veno-venous ECMO in a patient with near-drowning-related severe ARDS: a case report and literature review.BMC anesthesiology · 2026Review
- Prehospital factors associated with ICU admission in drowning patients: a retrospective multicenter cohort study in a French coastal region.BMC emergency medicine · 2026Observational
- Hesperidin-β-Cyclodextrin inclusion complexes: A novel approach for preventing and treating acute lung injury caused by seawater drowning.International journal of pharmaceutics: X · 2025Article
- Mesenchymal stem cell treatment alleviates seawater drowning induced lung injury by inhibiting the TNFα/Snail/EMT pathway.Journal of thoracic disease · 2024Article
- MicroRNA‑200c‑3p regulates seawater‑induced acute lung injury via ANGII and ACE2/ANG1‑7 pathways.Experimental and therapeutic medicine · 2023Article
- Omadacycline for the treatment ofWorld journal of emergency medicine · 2023Article
- Early platelet dysfunction in patients receiving extracorporeal membrane oxygenation is associated with mortality.Journal of thrombosis and thrombolysis · 2022Observational
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Authors and funding
19 authors at 14 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDrowning is a global threat and one of the leading causes of injury around the world. The impact of drowning conditions including water salinity on patients' prognosis remains poorly explored in Intensive Care Units (ICUs) patients.
methodsWe conducted a retrospective multicenter study on patients admitted to 14 ICUs in the west of France from January 2013 to January 2020. We first compared demographic and clinical characteristics at admission as well as clinical courses of these patients according to the salinity of drowning water. Then, we aimed to identify variables associated with 28-day survival using a Cox proportional hazard model.
resultsOf the 270 consecutive included patients, drowning occurred in seawater in 199 patients (73.7%) and in freshwater in 71 patients (26.3%). Day-28 mortality was observed in 55 patients (20.4%). Freshwater was independently associated with 28-day mortality (Adjusted Hazard Ratio (aHR) 1.84 [95% Confidence Interval (CI) 1.03-3.29], p = 0.04). A higher proportion of freshwater patients presented psychiatric comorbidities (47.9 vs. 19.1%; p < 0.0001) and the etiology of drowning appeared more frequently to be a suicide attempt in this population (25.7 vs. 4.2%; p < 0.0001). The other factors independently associated with 28-day mortality were the occurrence of a drowning-related cardiac arrest (aHR 11.5 [95% CI 2.51-52.43], p = 0.0017), duration of cardiopulmonary resuscitation (aHR 1.05 [95% CI 1.03-1.07], p < 0.0001) and SOFA score at day 1 (aHR 1.2 [95% CI 1.11-1.3], p < 0.0001).
conclusionsIn this large multicenter cohort, freshwater drowning patients had a poorer prognosis than saltwater drowning patients. Reasons for such discrepancies include differences in underlying psychiatric comorbidity, drowning circumstances and severities. Patients with initial cardiac arrest secondary to drowning remain with a very poor prognosis.
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