Format

Send to

Choose Destination
Chest. 1997 Sep;112(3):660-5.

Near-drowning and drowning classification: a proposal to stratify mortality based on the analysis of 1,831 cases.

Author information

1
Fire Department of Rio de Janeiro, Near-Drowning Recuperation Center of Barra da Tijuca, Miguel Couto Municipal Hospital, Brazil. sobrasa@ccard.com.br

Abstract

STUDY OBJECTIVE:

To establish an updated classification for near-drowning and drowning (ND/D) according to severity, based on mortality rate of the subgroups.

MATERIALS AND METHODS:

We reviewed 41,279 cases of predominantly sea water rescues from the coastal area of Rio de Janeiro City, Brazil, from 1972 to 1991. Of this total, 2,304 cases (5.5%) were referred to the Near-Drowning Recuperation Center, and this group was used as the study database. At the accident site, the following clinical parameters were recorded: presence of breathing, arterial pulse, pulmonary auscultation, and arterial BP. Cases lacking records of clinical parameters were not studied. The ND/D were classified in six subgroups: grade 1--normal pulmonary auscultation with coughing; grade 2--abnormal pulmonary auscultation with rales in some pulmonary fields; grade 3--pulmonary auscultation of acute pulmonary edema without arterial hypotension; grade 4--pulmonary auscultation of acute pulmonary edema with arterial hypotension; grade 5--isolated respiratory arrest; and grade 6--cardiopulmonary arrest.

RESULTS:

From 2,304 cases in the database, 1,831 cases presented all clinical parameters recorded and were selected for classification. From these 1,831 cases, 1,189 (65%) were classified as grade 1 (mortality=0%); 338 (18.4%) as grade 2 (mortality=0.6%); 58 (3.2%) as grade 3 (mortality=5.2%); 36 (2%) as grade 4 (mortality=19.4%); 25 (1.4%) as grade 5 (mortality=44%); and 185 (10%) as grade 6 (mortality=93%) (p<0.000001).

CONCLUSION:

The study revealed that it is possible to establish six subgroups based on mortality rate by applying clinical criteria obtained from first-aid observations. These subgroups constitute the basis of a new classification.

PMID:
9315798
DOI:
10.1378/chest.112.3.660
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center