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Table 3 Included papers on female drowning clinical treatment and outcomes (n = 5)

From: A scoping review of female drowning: an underexplored issue in five high-income countries

Author

Country

Study aim

Study Design/Methodology

Study sample

Results

Evidence Hierarchy [34]/GRADE [35]

Limitations

El Sibai et al. (2018) [4]

United States

To describe the characteristics and predictors of poor outcome among ED presentations for drowning

Design: Retrospective cross-sectional study

Data Collection: NEDS dataset, 2013

Females n = 4283/12529 (34.2%)

Multivariate analysis results report significant positive predictor of poor outcomes among males.

Over half of patients were discharged home from ED.

Level IV-Low level evidence

GRADE-Very low

NEDS data represents 20% of US hospital based ED’s. Errors reported in injury coding for submersion therefore some drownings missed.

Lee et al. (2006) [36]

United States

To describe the epidemiology and outcomes of serious paediatric submersion, and identify factors associated with increased mortality and morbidity.

Design: Retrospective case-series

Data collection: Massachusetts electronic death database from Department of Public Health Registry of Vital Records and Statistics, and Massachusetts Hospital discharge Database from 1994 to 2000. Ages 0–19 years

Females n = 89/267 (33%)

Males were 2.52 times more likely to have a poor outcome than females (mortality and morbidity)

Level IV-Low level evidence

GRADE-Very low

Limitations in data collected from databases such as quality, duplicates or missed cases. Data only contained patients admitted to hospital wards as ED state-wide data was not available.

Quan et al. (2014) [37]

United States, United Kingdom, Australia

To assess the association between water temperature and duration of submersion in the outcome of drowning.

Design: Case-control study

Data collection: Western Washington database, January 1974 to June 1996. Data collection was limited to unintentional drowning that occurred in open waters (lakes, rivers and oceans)

Females n = 161/1094 (15%)

Good outcome (survived with or without limited neurological deficit or injury): Females n = 69/276 (24.9%)

Good outcome associated with age less than 15 years, female and immersion duration of less than 6 min in water greater than 16 degrees Celsius.

Level III-3-Low level evidence

GRADE-Very low

Retrospective data collection limitations with hand searching, although authors believe high case ascertainment from this method. Water temperatures were estimated, as not routinely collected at the time of the drowning incident.

Reynolds et al. (2017) [38]

United States

To estimate long-term mortality and identify prognostic factors in drowning victims.

Design: Cohort study

Data collection: Western Washing Drowning Registry on non-fatal drowning incidents from January 1974 to July 1996.

Females n = 247/776 (31.8%)

Long-term mortality: univariate analysis for Male sex –non-significant (Cox proportional hazard modelling).

Level III-3-Low level evidence

GRADE-Very low

Difficult to predict long-term survival from drowning event due to accuracy of coding data, although this association suggested.

Reynolds et al. (2019) [39]

United States

To estimate long-term survival after cardiac arrest from drowning.

Design: Cohort Study

Data collection: Western Washington Drowning Registry on non-fatal drowning incidents. January 1974 to July 1996.

Females n = 109/407 (26.8%) (Survived to hospital admission)

Long-term survival: Females n = 18/54 (33.3%)

Level III-3-Low level evidence

GRADE-Very low

Missing data, only variables with less than 25% missing data were included in multivariate analysis.

  1. Legend: ED emergency department; GRADE Grading of Recommendations Assessment, Development and Evaluation guidelines; NEDS Nationwide Emergency Department Sample (USA)