Advanced Search
Korean J Pediatr 2016 May;59(5) :212-217.
Published online 2016 May 15.        doi:
Clinical features and prognostic factors in drowning children: a regional experience
Kyung Lae Son1, Su Kyeong Hwang2, Hee Joung Choi1
1Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea
2Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Korea
Corresponding Author: Hee Joung Choi ,Tel: +82-53-250-7524, Fax: +82-53-250-7783, Email:
Copyright © 2016 by The Korean Pediatric Society
Purpose: This study aimed to evaluate the clinical features of children who have survived a water submersion incident, and to identify risk factors for prognosis.
Methods: We retrospectively reviewed the medical records of patients who experienced submersion between January 2005 and December 2014. The patients were classified into 2 groups, according to complications, and prognostic factors were evaluated.
Results: During the study period, 29 children experienced submersion (20 boys and 9 girls; mean age, 83.846.4 months). Submersion occurred most commonly in the summer, with the peak incidence in August. The most frequent Szpilman clinical score was grade 5 (13 patients; 44.8%), followed by grade 6 (7 patients; 24.1%), and grades 1 or 2 (3 patients; 10.3%). Five children (17.2%) in the poor prognosis group died or had hypoxic ischemic encephalopathy, and the overall mortality rate was 6.9%. Poor prognosis after submersion was associated with lower consciousness levels (P=0.003), higher Szpilman scores (P=0.007), greater need for intubation and mechanical ventilator support (P=0.001), and longer duration of oxygen therapy (P=0.015). Poor prognosis was also associated with lower bicarbonate levels (P=0.038), as well as higher sodium, aspartate transaminase (AST), and alanine transaminase (ALT) levels (P=0.034, P=0.006, and P=0.005, respectively). Szpilman clinical scores were positively correlated with consciousness levels (r=0.489, P=0.002) and serum liver enzyme levels (AST and ALT; r=0.521, P=0.004).
Conclusion: We characterized the prognostic factors associated with submersion outcomes, using the Szpilman clinical score, which is comparable to consciousness level for predicting mortality.
Keywords: Drowning | Child | Prognosis
PDF Links  PDF Links
Full text via DOI  Full text via DOI
Download Citation  Download Citation
Supplementary Material  Supplementary Material
Characteristics and prognosis of hepatic cytomegalovirus infection in children: 10 years of experience at a university hospital in Korea  2017 August;60(8)
Clinical course and prognostic factors of childhood immune thrombocytopenia: single center experience of 10 years   2016 July;59(8)
Clinical importance of F-waves as a prognostic factor in Guillain-Barré syndrome in children  2016 June;59(6)
Clinical characteristics of lung abscess in children:15-year experience at two university hospitals  2015 December;58(12)
Prevalence and risk factors for vitamin D deficiency in children with iron deficiency anemia  2012 June;55(6)
Register for e-submission
Register here to access the e-submission system of Korean J Pediatr for authors and reviewers.
Manuscript Submission
To submit a manuscript, please visit the Korean J Pediatr e-submission management system at, read the Instructions for Authors, and log into the Korean J Pediatr e-submission system. For assistance with manuscript submission, please contact:
Free archive
Anyone may access any past or current articles without logging in.
Korean Pediatric Society Office
#1606, Seocho World Officetel, 19 Seoun-ro, Seocho-gu, Seoul 137-070, Korea
TEL : +82-2-3473-7305    FAX : +82-2-3473-7307   E-mail:
BrowseCurrent IssueFor Authors and ReviewersAbout
Copyright© The Korean Pediatric Society. All right reserved.