Objective We evaluated prognostic factors for pediatric drowning patients. The association between functional outcomes and clinical factors was investigated.
Methods A retrospective cohort study was conducted using data for pediatric drowning patients from the Korean Community-based Severe Trauma Survey from 2016 to 2020. The primary outcome was a good prognosis at discharge, defined as a Glasgow Outcome Scale score of 5. A multivariable logistic regression analysis was performed to evaluate independent factors associated with the primary outcome.
Results From 237,616 patients, we identified 406 drowning patients aged ≤19 years (mean age, 8.8 years). At discharge, 41.0% of those patients had a good recovery. The absence of prehospital cardiac arrest (adjusted odds ratio [aOR], 98.7; 95% confidence interval [CI], 32.9–295.8), indoor location (aOR, 4.0; 95% CI, 1.7–9.3), and transfer to a high-volume hospital (aOR, 2.5; 95% CI, 1.1–5.8) were significant independent factors associated with a good outcome. Age, sex, the intent of injury, and prehospital time were not associated with the outcome.
Conclusion Our study identified independent prognostic factors for drowning patients, highlighting the importance of prehospital conditions and hospital care settings in determining outcomes. These findings could be useful in developing clinical strategies for managing such patients.
Citations
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Age group-related characteristics of pediatric drowning patients treated at an emergency medical center in northern Yeongseo, Gangwon Province Hyunseok Cho, Jin-Sung Park, Yonghee Lee, Juyeon Jeon Pediatric Emergency Medicine Journal.2026; 13(2): 51. CrossRef
Prognostic Value of the Szpilman Classification, Blood Lactate Levels, and Systemic Inflammatory Indices in Pediatric Drowning Patients Zeynep Tanyeli, Utku Özer, Şener Çınıçev, Zeliha Akman Üsgüloğlu, Sinem Sarı Gökay Pediatric Emergency Care.2026;[Epub] CrossRef
Clinical factors associated with mortality in pediatric seawater drowning: a 13-year emergency department experience from a Turkish coastal province Şeyma Şimşirgil Kara, Teoman Erşen, Özhan Özcan, Sema Tural Bozoğlu, Dilek Sağır, Kıvanç Öncü Frontiers in Pediatrics.2026;[Epub] CrossRef
Objective Individual experience with opioids is highly variable. Some patients with acute pain do not experience pain relief with opioids, and many report no euphoria or dysphoric reactions. In this study, we describe the clinical phenotypes of patients who receive intravenous opioids.
Methods This was an emergency department-based study in which we enrolled patients who received an intravenous opioid. We collected 0 to 10 pain scores prior to opioid administration and 15 minutes after. We also used 0 to 10 instruments to determine how high and how much euphoria the patient felt after receipt of the opioid. Using a cutoff point of ≥50% improvement in pain and the median score on the high and euphoria scales, we assigned each participant to one of the following clinical phenotypes: pain relief with feeling high or euphoria, pain relief without feeling high or euphoria, inadequate relief with feeling high or euphoria, and inadequate relief without feeling high or euphoria.
Results A total of 713 patients were enrolled, 409 (57%) of whom reported not feeling high, and 465 (65%) reported no feeling of euphoria. Median percent improvement in pain was 37.5% (interquartile range, 12.5%–60.0%). One hundred seventy-eight participants (25%) were classified as experiencing pain relief with euphoria or feeling high, 190 (27%) experienced inadequate relief with euphoria or feeling high, 101 (14%) experienced pain relief without euphoria or feeling high, and 244 (34%) reported inadequate relief without euphoria or feeling high.
Conclusion Among patients who receive intravenous opioids in the emergency department, the experiences of pain relief and euphoria are highly variable. For many, pain relief is independent of feeling high.
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Association of acute opioid-induced euphoria and analgesia with subsequent opioid prescriptions in an emergency department–based prospective cohort study Spencer Brown, Eddie Irizarry, Andrew Williams, Michelle Davitt, Jesse Baer, Benjamin W. Friedman Clinical and Experimental Emergency Medicine.2026; 13(2): 207. CrossRef
A Prospective Cohort Study to Determine Which Opioid-Naïve Emergency Department Patients Are at Risk of Persistent Opioid Use Lorena Abril, Lauren Gilbert, Fernanda Pacheco, Mai Takematsu, Michelle Davitt, Kristen Schimmrich, Jesse Baer, Gregory Mazarin, Chiraag Gupta, Victoria Adewunmi, Eddie Irizarry, Benjamin W. Friedman Annals of Emergency Medicine.2025; 86(2): 179. CrossRef
The burden of acute pain in the U.S. in the wake of the opioid crisis James C. Hackworth, John E. Schneider, Maggie Do Valle, David Fam, Charles Argoff, Emanuela Offidani, Jim Potenziano Frontiers in Pain Research.2025;[Epub] CrossRef
Clinical phenotypes and short-term outcomes based on prehospital point-of-care testing and on-scene vital signs Raúl López-Izquierdo, Carlos del Pozo Vegas, Ancor Sanz-García, Agustín Mayo Íscar, Miguel A. Castro Villamor, Eduardo Silva Alvarado, Santos Gracia Villar, Luis Alonso Dzul López, Silvia Aparicio Obregón, Rubén Calderon Iglesias, Joan B. Soriano, Francis npj Digital Medicine.2024;[Epub] CrossRef
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