TY  - JOUR
PY  - 2021//
TI  - Clinical spectrum and risk factors for mortality among seawater and freshwater critically ill drowning patients: a French multicenter study
JO  - Critical care : the Official Journal of the Critical Care Forum
A1  - Reizine, Florian
A1  - Delbove, Agathe
A1  - Dos Santos, Alexandre
A1  - Bodenes, Laetitia
A1  - Bouju, Pierre
A1  - Fillatre, Pierre
A1  - Frérou, Aurélien
A1  - Halley, Guillaume
A1  - Lesieur, Olivier
A1  - Jonas, Maud
A1  - Berteau, Florian
A1  - Morin, Jean
A1  - Luque-Paz, David
A1  - Marnai, Rémy
A1  - Le Meur, Anthony
A1  - Aubron, Cécile
A1  - Reignier, Jean
A1  - Tadié, Jean-Marc
A1  - Gacouin, Arnaud
SP  - e372
EP  - e372
VL  - 25
IS  - 1
N2  - BACKGROUND: Drowning 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. <br><br>METHODS: We 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. <br><br>RESULTS: Of 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). <br><br>CONCLUSIONS: In 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.<p />  <p>Language: en</p>
LA  - en
SN  - 1364-8535
UR  - http://dx.doi.org/10.1186/s13054-021-03792-2
ID  - ref1
ER  -