Étude descriptive des noyades en France

Abstract : Objectives: The aim of our study was to analyse the distribution of drowning patients admitted in our hospital with the classification of Szpilman, to define mortality of each category and to describe the clinical and ventilatory profile of patients from these different stages. Methods: We realised an observational retrospective study with a multicentre collection conducted from 2014 to 2017 in French Polynesia, French Antilles and France. Drowning patients older than 15 years old admitted to ICU or emergency departments have been included. The aim of our study was to describe the distribution of drowning patients with Szpilman’s classification, then to define the mortality of each category. The secondary goals were to describe the clinical, gasometric and ventilatory profil of patients from these different stages. Results: 312 patients have been included. 63,5% were men. The median age was 57 years old 40-70. During the initial assessment , 49,8% of patients were conscious, 6,9% had a Glasgow Coma Scale (GCS) between 9 and 12 and 43,2% had a GCS higher than or equal to 13. 47,5% of patients went through mechanical ventilation (MV). 15,5% to non-invasive ventilation (NIV). 31,3% had benefited from an oxygen therapy. According to the classification of Szpilman, 6,5% of patients were distributed into grade 2, 13,2% into grade 3, 2,6% into grade 4, 15,8% into grade 5 and 31,9% into grade 6.The global mortality was 18,5%. The mortality by grade was 0% into grade 2 and 4, 2% into grade 3 and 5, and 54% into grade 6. Conclusion: Drowning is still a current circumstantial pathology whose prognosis is not so dark. The gravity of the initial clinical presentation of drowning patients in France seems to be less critical nowadays. We observe a bimodal neurological distribution of drowning patients and the presence of isolated respiratory failure in majority of conscious drowning patients. It could lead to two possible strategies of ventilation : MV for unconscious patients and NIV for drowning patients without neurological and hemodynamic failure.
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Manon Frebourg. Étude descriptive des noyades en France. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02171879⟩

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