Abstract
Purpose
Accidental drowning can cause out-of-hospital cardiac arrest (OHCA). We investigated
the effect of drowning location on outcomes of individuals who experienced drowning-OHCA.
Methods
All cases of emergency medical service–treated drowning-OHCA in South Korea from January
2006 to December 2013 were analyzed. Cases were excluded if there was a preceding
injury, no information on event location, or suicide. Cases were divided into 4 groups:
recreational water with mandatory safety regulations (group 1, public swimming pool;
group 2, beach) and nonrecreational water without mandatory safety regulations (group
3, natural freshwater; group 4, seawater). The main outcome was survival to hospital
discharge. Multiple logistic regression analysis was conducted using natural freshwater
as the reference location.
Results
We analyzed 1691 drowning-OHCAs (public swimming pools, 3.4%; public beaches, 5.2%;
unsupervised seawater, 33.8%; and unsupervised open freshwater, 57.6%). The rate of
survival to discharge was 4.6% for all cases, 17.5% for cases in public swimming pools,
9.1% for cases in public beaches, 4.9% for cases in unsupervised seawater, and 3.3%
for cases in unsupervised open freshwater (p < 0.01). The adjusted odds ratios (95% confidence intervals [CIs]) for survival relative
to natural freshwater were 3.97 (95% CI, 1.77-8.89) for public swimming pools, 2.81
(95% CI, 1.22-6.45) for public beaches, and 1.54 (95% CI, 0.88-2.70) for unsupervised
seawater.
Conclusion
Individuals who experience drowning-OHCA in public locations with safety regulations
had a better rate of survival. There should be improved public awareness of the significantly
greater risk of drowning-OHCA in locations that have no safety regulations.
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Article Info
Publication History
Published online: June 07, 2016
Accepted:
June 2,
2016
Received in revised form:
May 23,
2016
Received:
March 10,
2016
Footnotes
☆This study was supported by the National Emergency Management Agency of Korea and the Korea Centers for Disease Control and Prevention. The study was funded by the Seoul Metropolitan City Government (2008) and the Korea Centers for Disease Control and Prevention (2008-2013).
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
