International maritime health · 2026
A 4-year retrospective descriptive study on treatment outcomes of decompression illness patients in various hyperbaric chamber centers in Thailand.
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Jittanonta Poonsak, Vongvanich Chanon, Premmaneesakul Hansa
Аннотация
BACKGROUND: Thailand is situated between two abundant bodies of water, the Andaman Sea and the Gulf of Thailand. Therefore, multiple industries are based around these waters. One of the largest economic incomes is from tourism, where recreational diving is a popular activity with multiple dive sites scattered across multiple provinces in Thailand. Moreover, there are types of diving such as military diving, occupational diving, and traditional (fishermen) diving.
MATERIAL AND METHODS: A retrospective descriptive study reviewing medical records of 178 decompression illness (DCI) patients from various hyperbaric chamber centers in Thailand, between January 2020 to December 2023.
RESULTS: Out of all the patients, 73.6% achieved complete resolution of symptoms, while 26.4% had residual symptoms. Traditional divers were at a higher risk of having residual symptoms after treatment (42%). Missing safety stops showed significant association with incomplete treatment outcomes (p = 0.008), univariate logistic regression confirmed significance (OR = 2.495, 95% CI: 1.263-4.926, p = 0.008); after multivariate logistic regression this factor lost its significance, but remained a strong predictor (adjusted OR = = 2.208, 95% CI: 0.962-5.069, p = 0.062). As for affected organs, spinal cord involvement was strongly related to incomplete outcomes (p = 0.001). First-aid high flow oxygen was given to only 18.5% of patients but had no significant associations with treatment outcomes.
CONCLUSIONS: This study was one of the first multi-center studies in Thailand, it raises multiple concerns for the diving industry in both the traditional and recreational sector. Both sectors can benefit from targeted education for divers, creating safety standards, and providing proper first-aid and treatment.
MATERIAL AND METHODS: A retrospective descriptive study reviewing medical records of 178 decompression illness (DCI) patients from various hyperbaric chamber centers in Thailand, between January 2020 to December 2023.
RESULTS: Out of all the patients, 73.6% achieved complete resolution of symptoms, while 26.4% had residual symptoms. Traditional divers were at a higher risk of having residual symptoms after treatment (42%). Missing safety stops showed significant association with incomplete treatment outcomes (p = 0.008), univariate logistic regression confirmed significance (OR = 2.495, 95% CI: 1.263-4.926, p = 0.008); after multivariate logistic regression this factor lost its significance, but remained a strong predictor (adjusted OR = = 2.208, 95% CI: 0.962-5.069, p = 0.062). As for affected organs, spinal cord involvement was strongly related to incomplete outcomes (p = 0.001). First-aid high flow oxygen was given to only 18.5% of patients but had no significant associations with treatment outcomes.
CONCLUSIONS: This study was one of the first multi-center studies in Thailand, it raises multiple concerns for the diving industry in both the traditional and recreational sector. Both sectors can benefit from targeted education for divers, creating safety standards, and providing proper first-aid and treatment.