Predicting mortality and safe discharge in drowning victims: A comprehensive analysis of neurological and clinical outcomes in the emergency department
Süleyman Gökhan Kara1,2
, Başak Bayram3, Şebnem Şakar Halaç4, Osman Sönmez5, Neşe Çolak6
1Department of Emergency Medicine, Ministry of Health Eskişehir City Hospital, Eskişehir, Türkiye
2Department of Stem Cell, Institute of Health Sciences, Eskişehir Osmangazi University, Eskişehir, Türkiye
3Chief Physician, İzmir Metropolitan Municipality Eşrefpaşa Hospital, İzmir, Türkiye
4Department of Emergency Medicine, Ministry of Health Fethiye State Hospital, Muğla, Türkiye
5Department of Emergency Medicine, Ministry of Health Tire State Hospital, İzmir, Türkiye
6Department of Emergency Medicine, İzmir Tepecik Training and Research Hospital, İzmir, Türkiye
Keywords: Drowning, emergency medicine, Glasgow Coma Scale, neurological outcomes, resuscitation
Abstract
OBJECTIVES: This study sought to identify risk factors linked to mortality, intensive care unit admission, and poor neurological outcomes among drowning victims and to find markers for safe discharge from the emergency department (ED).
METHODS: This retrospective cross sectional study evaluated all drowning victims presenting to both adult and pediatric EDs at a single center over an 11 year period. Variables such as arrival time at ED, age, type of water, comorbid diseases, vital signs, treatments given, and prehospital interventions were assessed.
RESULTS: The study found that early basic life support (BLS) by bystanders significantly improves survival and neurological outcomes. Respiratory rate, oxygen saturation, and Glasgow Coma Scale (GCS) were identified as independent risk factors for poor clinical outcomes. While the Szpilman clinical score is useful, it alone is not sufficient for predicting poor clinical outcomes.
CONCLUSIONS: For optimal management of drowning victims, immediate BLS is crucial. In the ED, respiratory rate, oxygen saturation, and GCS should be closely monitored. Drowning victims with a GCS of 15, normal respiratory rate, normal oxygen saturation, and Szpilman score below 3 can be safely discharged from the ED.
How to cite this article: Kara SG, Bayram B, Halaç ŞŞ, Sönmez O, Çolak N. Predicting mortality and safe discharge in drowning victims: A comprehensive analysis of neurological and clinical outcomes in the emergency department. Turk J Emerg Med 2025;25:208-15.
Ethical approval for this study was obtained from the Non‑Interventional Ethics Committee of Dokuz Eylül University Faculty of Medicine (Decision No: 2019/11‑12, Date: April 24, 2019).
S.G.K. (Süleyman Gökhan Kara): Conceptualization (lead), Methodology (lead), Data Curation (lead), Writing – Original Draft (lead), Investigation (equal).
B.B. (Başak Bayram): Project Administration (lead), Supervision (lead), Validation (equal), Writing – Review and Editing (equal).
Ş.S.H. (Şebnem Şakar Halaç): Formal Analysis (equal), Data Collection (equal), Writing – Review and Editing (equal).
O.S. (Osman Sönmez): Resources (equal), Visualization (equal), Writing – Review and Editing (supporting).
N.Ç. (Neşe Çolak): Project Administration (equal), Supervision (equal), Funding Acquisition (equal).
None Declared.
None.
We extend our gratitude to the teams at Dokuz Eylül University Hospital Adult and Pediatric Emergency Departments for their unwavering support throughout this study. Special thanks to our colleagues for their invaluable insights and critiques, which greatly enriched our research.