Clinical factors associated with mortality in pediatric seawater drowning: a 13-year emergency department experience from a Turkish coastal province

İngilizce (OpenAlex)

Introduction Pediatric drowning remains a leading cause of preventable childhood mortality, yet epidemiological and clinical data from coastal regions of Türkiye are scarce. Methods This retrospective cross-sectional study analyzed all pediatric seawater drowning cases (ages 0-18 years) admitted to a referral emergency department in a Turkish coastal province between July 2011 and July 2024, with the aim of describing demographic and clinical characteristics and identifying factors associated with in-hospital mortality. Results A total of 66 patients were included (mean age 10.64 ± 4.86 years; 60.6% male). The overall mortality rate was 10.6%. Over 90% of cases occurred in July or August, and nearly half involved non-resident visitors, reflecting the region's strong seasonal tourism pattern. Non-survivors were characterized by a Glasgow Coma Scale score of 3 and a median Szpilman score of 6 on admission, compared to scores of 15 and 1, respectively, among survivors ( p < 0.001). Significant laboratory differences between non-survivors and survivors included markedly lower arterial pH and bicarbonate, and higher pCO₂, lactate, creatinine, transaminases (AST, ALT), lactate dehydrogenase, sodium, and potassium levels (all p < 0.05). All non-survivors received cardiopulmonary resuscitation and required endotracheal intubation, while none of the survivors required resuscitation. Radiological lesions showed a non-significant trend toward higher prevalence in non-survivors. Discussion These findings indicate that neurological status on arrival, Szpilman score, arterial blood gas parameters, and specific biochemical markers may serve as early indicators associated with mortality to support risk stratification in pediatric drowning. Region-specific prevention strategies targeting adolescents and seasonal visitors, combined with rapid prehospital response, remain critical to reducing drowning-related mortality.