Morbidity and Mortality of Drowning Children in Jerusalem District - Retrospective Analysis

Background: Drowning persists as a preventable pediatric cause of severe morbidity and mortality. This study aims to investigate the risk factors, circumstances, and medical consequences associated with pediatric drowning incidents in order to identify patterns that can inform targeted interventions. Methods: This was a retrospective analysis of a cohort of pediatric drowning cases. The study encompassed children aged 0-18 years who presented to the pediatric emergency departments (PEDs) of Hadassah Medical Centers in Jerusalem from January 1, 2004 through April 30, 2023. Inclusion criteria were individuals with main registration diagnosis containing the terms "drowning"or "submersion."Results: Analysis revealed 129 cases of pediatric drowning, males comprising 66% of the cohort. The average age was 4.9 years (SD = 4.5). Predominantly, drownings occurred in private (38%) or public pools (27.1%). Forty-eight percent of children required hospitalization in intensive care. Notably, children from the Arab minority were significantly younger at the time of drowning (3.8 years; P =.04) and were at elevated risk of severe neurologic outcomes necessitating rehabilitation (P =.03). Incidents occurring on weekends were associated with younger victim ages (3.5 years; P =.04) and with increased likelihood of outcomes necessitating rehabilitation (P =.04). Conversely, children from families with four or more siblings were notably older at the time of drowning (5.3 years; P =.01). No other statistically significant differences were observed among demographic groups. Conclusions: Strategies aimed at promoting child health and preventing drowning must surmount feasibility barriers. Intervention efforts should be tailored to populations at heightened risk, including younger children, minority groups, and incidents occurring during weekends.