Neurocognitive outcomes in children following immersion: a long-term study

• Published in: Archives of disease in childhood 2018-08, Vol.103 (8), p.784-789
• Main Authors: Manglick, Maria Patricia, Ross, Frank I, Waugh, Mary-Clare, Holland, Andrew J A, Cass, Daniel T, Soundappan, Soundappan S V
• Format: Article
• Language: English
• Subjects: Age; Brain; Children; Children & youth; Cognition; Complications; Death; Departments; Drowning; Executive function; Flow Charts; Followup Studies; Hospitals; Hypoxia; Injuries; Intellectual disabilities; Learning Problems; Males; Morbidity; Mortality; Motor skill; Patient admissions; Pediatrics; Population; Preschool children; Rivers; Swimming pools; Traumatic brain injury; Water temperature
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2017-314051

ObjectiveTo investigate long-term neurocognitive outcomes after a near-drowning incident in children who were deemed neurologically intact on discharge from hospital.DesignA prospective cohort study of near-drowning children.Setting95 drowning and near-drowning admissions, 0–16 years of age, from January 2009 to December 2013, to The Children’s Hospital at Westmead, Sydney, NSW, Australia.Participants23 children both met the criteria and had parental consent for the study.Main outcome measuresIdentification of the long-term deficits in behaviour, executive function, motor skills, communicative skills and well-being over a 5-year period. Assessment was undertaken at 3–6 months, 1 year, 3 years and 5 years after near-drowning at clinic visits. Physical developmental screening and executive function screening were done using Behavior Rating Inventory of Executive Function-Preschool version (BRIEF-P) and BRIEF.Result95 drowning and near-drowning episodes occurred during the study period. 10 (11%) children died, 28 were admitted to the paediatric intensive care unit and 64 directly to a ward. 3 children died in emergency department, 7 children had severe neurological deficit on discharge from the hospital. 23 were subsequently recruited into the study; 5 (22%) of these children had abnormalities in behaviour and/or executive function at some during their follow-up.ConclusionChildren admitted to hospital following a near-drowning event warrant long-term follow-up to identify any subtle sequelae which might be amenable to intervention to ensure optimal patient outcome.