@article{ref1,
title="Long-term neurocognitive outcomes in pediatric non-fatal drowning: results of a family caregiver survey",
journal="Pediatric neurology",
year="2023",
author="Razaqyar, Muslima S. and Osta, Eri and Towne, Jonathan M. and Woolsey, Mary D. and Ishaque, Mariam and Chiang, Florence L. and Fox, Peter T.",
volume="151",
number="",
pages="21-28",
abstract="Background and Objectives Drowning is a leading cause of brain injury in children. Long-term outcome data for drowning survivors are sparse. This study reports neurocognitive outcomes for 154 children hospitalized following drowning.  Methods A survey for parent caregivers was distributed online. Likert-scale items assessed ten outcome variables in four domains: motor (3), perception (3), language (3), and social/emotional (1). Cluster analysis, outcome relative risk, and descriptive statistics were applied.  Results 208 surveys were received; 154 met inclusion criteria. Coma was the most common admission status (n = 137). Cluster analysis identified 3 outcome groups: Mild (n, 39), Moderate (n, 75), and Severe (n, 40). Motor impairment with cognitive and perceptual sparing (deefferentation) was present in Moderate (p < 1 x 10-26) and Severe groups (p <1 x 10-12) but absent in Mild. Congruously, locked-in state was endorsed in both the Moderate (83%) and Severe (70%) groups. The strongest predictor of good outcome (Mild group) was hospitalization with no medical intervention (RR=6.7). Responsivity on admission (RR = 4.2) or discharge (RR = 12.22) also predicted good outcome. In-hospital prognostication and counseling predicted outcome weakly (RR = 1.3) or not at all.  Conclusions Long-term outcomes in pediatric drowning ranged widely. On average, motor impairments exceeded perceptual or cognitive impairments (p <1 x 10-18), with &quot;locked-in syndrome&quot; endorsed in the majority (93 of 154). The strongest predictors of good outcome were the lack of necessity for interventions, and responsivity on admission or discharge. The eponym &quot;Conrad's Syndrome&quot; is proposed for locked-in state following non-fatal drowning in children.<p /> <p>Language: en</p>",
language="en",
issn="0887-8994",
doi="10.1016/j.pediatrneurol.2023.11.001",
url="http://dx.doi.org/10.1016/j.pediatrneurol.2023.11.001"
}