Drowning in the Eastern Mediterranean region: a systematic literature review of the epidemiology, risk factors and strategies for prevention

Peden, Amy E.; Işın, Ali

doi:10.1186/s12889-022-13778-6

Table 3 Coded risk and protective factors for fatal and non-fatal drowning in the Eastern Mediterranean Region

From: Drowning in the Eastern Mediterranean region: a systematic literature review of the epidemiology, risk factors and strategies for prevention

Risk/Protective Factor	Specific detail	Drowning outcome	Study population	Country (Reference)
Absence of vital signs	Absence of vital signs	Fatal	0–15 years	Iran [51]
Absence of vital signs	Absence of vital signs in emergency room	Brain death or severe neurological disease	1–13 years	Saudi Arabia [63]
Accidental intent	More likely to be of accidental than due to suicide or homicide	Fatal	0–18 years	Iran [58]
Adult supervision	Unsupervised by adults	Fatal	0–13 years	Saudi Arabia [60]
Age	1–4 years age group	Fatal and non-fatal	0–13 years	Bahrain [30]
	Children ≤5 years	Fatal	0–17 years	Saudi Arabia [31]
	Children 1–4 years	Fatal	0–18 years	Iran [58]
Blood sugar level	Blood sugar of ≥10 mmol/L	Brain death or severe neurological disease	1–13 years	Saudi Arabia [63]
Death at scene	Location of death more likely to be at the scene for drowning	Fatal	0–18 years	Iran [58]
Delay in initiating resuscitation	Delay in initiating resuscitation	Fatal or leading to neurological damage	0–14 years	Saudi Arabia [32]
Glasgow Coma Scale (GCS) score	High GCS score upon admission ^a	Complete recovery	0–14 years	Saudi Arabia [32]
	High GCS score upon end of care ^a	Complete recovery	0–14 years	Saudi Arabia [32]
	GCS score < 5	Fatal	0–15 years	Iran [51]
	GCS score ≤ 4	Brain death or severe neurological disease	1–13 years	Saudi Arabia [63]
Length of hospital stay	Decreased length of stay ^a	Complete recovery	0–14 years	Saudi Arabia [32]
Mother with helper or older children	Self-reporting leaving infant unattended in the bathtub	Non-fatal	Parents of infants	Saudi Arabia [68]
Non-lifeguarded areas	Non-lifeguarded areas	Fatal	All ages	Iran [59]
pH level	pH < 7.2	Fatal	0–15 years	Iran [51]
pH level	Arterial pH of ≤7	Brain death or severe neurological disease	1–13 years	Saudi Arabia [63]
Resident status	Tourists more likely to drown than local residents	Revived (subsequently fatal)	All age	Iran [59]
	Tourists drowning in the sea	Fatal	All age	Iran [59]
	Local residents	Fatal	All age	Iran [59]
Seasonality	Winter and Autumn months	Fatal	0–13 years	Saudi Arabia [60]
Sex	Males	Fatal	All age	Iran [42]
	Males	Fatal	All age	Iran [40]
	Males	Fatal	All age	Iran [55]
	Males	Fatal	0–15 years	Iran [51]
	Males	Fatal	0–18 years	Iran [58]
	Males	Fatal	1–5 years	Qatar [94]
	Males	Fatal	0–17 years	Saudi Arabia [31]
	Females aged ≤14 years	Fatal	All age	Iran [59]
Submersion time	Longer submersion time	Fatal	0–13 years	Saudi Arabia [60]
	Submersion time > 5 minutes	Fatal	1–13 years	Saudi Arabia [63]
	Shorter submersion time (mean 3.5 minutes) ^a	Fatal or leading to neurological damage	0–14 years	Saudi Arabia [32]
Body temperature	Temperature ≥ 36 degrees ^a	Recovery	0–15 years	Iran [51]
Washing containers	Outcome worse when compared to pools	Fatal	0–13 years	Saudi Arabia [60]

^adenotes protective factor

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ISSN: 1471-2458

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