Outcomes and predictive factors in pediatric drowning: a systematic review and meta-analysis of prehospital predictors.

Purpose: Drowning ranks as the third leading cause of injury-related death in children globally. This systematic review and meta-analysis aims to provide a comprehensive assessment of mortality rates, and resuscitation success rates in pediatric populations.

Methods

A comprehensive literature search was conducted across four databases PubMed, Cochrane, Web of Science and Scopus for all original studies published till November 2024 with reported outcomes of drowning in the pediatric population. Outcomes evaluated include mortality, rate of discharge, neurological outcomes at discharge, and success rate of resuscitation.

Results

Twenty-four studies encompassing 2,436 pediatric drowning cases were analyzed. The pooled mortality rate was 24% (95% CI [0.17, 0.34]), underscoring the critical fatality risk. The pooled discharge rate was 63% (95% CI [0.47, 0.76]), indicating favorable recovery for most cases. However, one-third of patients exhibited significant neurological deficits. Resuscitation success was achieved in 39% (95% CI [0.32, 0.48]), with bystander resuscitation demonstrating nearly double the success rates compared to emergency medical personnel or lifeguards.

Conclusion

Despite favorable discharge rates, pediatric drowning remains a major public health challenge with high mortality and neurological impairment rates. Urgent action is required to develop standardized management protocols and prevention strategies, particularly in resource-limited settings.