Drowning classification: a reappraisal of clinical presentation and prognosis for severe cases

Abstract Background Drowning still a major cause of accidental death worldwide. In 1997, Szpilman proposed a classification of drowning that has become the reference. Over the last decades, considerable efforts have been made to improve prevention and care. It seemed appropriate to reassess the prognosis and clinical presentation of drowned patients more than 20 years after this first publication. The aim of our study was to provide a reappraisal of patients who needed advanced health care and a precise description of their respective neurological, respiratory, and hemodynamic profiles. Methods This retrospective study was conducted over four consecutive summer periods between 2014 and 2017 in Intensive Care Units (ICU) located in France, French Polynesia, and French Antilles. Patients were classified following the drowning classification system proposed by Szpilman. Results During the study period, 312 drowned patients were admitted with severe clinical presentation (Grade 2–6). All patients benefited from rapid extraction from the water ( Conclusion Based on our results, drowning-related cardiac arrest is still the prognosis cornerstone. For other victims, prognosis was better than previously expected, which strengthens the importance of specialized intervention to interrupt the drowning process.