Clinical characteristics of elderly drowning patients

Published:August 29, 2018DOI:



      Drowning is one of the major causes of traumatic death. The impact of drowning in the elderly and patients who were not elderly will be different because of physiological differences. We wanted to analyze the clinical differences such as mortality, incidence rate of complications, degree of hypothermia and rate of cardiac arrest between elderly and adult drowning patients.


      This study included drowning patients over 18 years old who came to an emergency department (ED) located on a riverside from September 1997 to July 2016. Patients over the age of 65 years were classified as elderly, while those under the age of 65 years were classified as adults. Demographic data and clinical outcomes were surveyed.


      A total of 611 patients were included in this study. Sixty-one patients (9.9%) were elderly, and 550 patients (90.1%) were adults. There were 17 elderly patients (15.8%) and 87 adult patients (27.9%) who had cardiac arrest at the time of ED arrival (p = 0.017). The rate of body temperatures < 34 °C was higher in elderly patients than that in adult patients (27.9% vs 17.5%, respectively, p = 0.025). The rates of hospitalization in the intensive care unit (ICU) and mortality were higher in elderly group (23% vs. 15.1%, respectively, p = 0.01; 37.7% vs 21.8%, respectively, p = 0.01). There was no significant difference in suicidal intent between the elderly and adult patient groups (82.0% vs 78.9%, respectively, p = 0.421).


      Elderly drowning patients accounted for approximately 1/10 of all drowning cases and were more likely to experience a cardiac arrest, hypothermia, mortality, and ICU admission.


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        • WHO
        Drowning fact sheet.
      1. Oxford Martin Programme on Global Development.
        • Kim K.
        • Kim J.Y.
        • Shin S.D.
        • Koh S.B.
        • Lee K.J.
        • Im J.S.
        • et al.
        The epidemiologic characteristics of drowning in Korea.
        Journal of the Korean Society of Emergency Medicine. 2008; 19: 527-534
        • KOSTAT
        Statistics Korea.
        (Available at:)
        • Seoul Metropolitan Government
        Date accessed: August 10, 2018
        • Woo S.H.
        • Park J.H.
        • Choi S.P.
        • Wee J.H.
        Comparison of clinical characteristics of intentional vs accidental drowning patients.
        Am J Emerg Med. 2015; 33: 1062-1065
        • KOSTAT
        Statistics Korea.
        (Available at:)
        • Shah M.N.
        Introduction: special content focus: geriatric emergency medicine.
        Acad Emerg Med. 2010; 17: 231
        • Huang J.F.
        • Wong R.H.
        • Chen C.C.
        • Mao I.F.
        • Huang C.C.
        • Chang W.H.
        • et al.
        Trajectory of depression symptoms and related factors in later life—a population based study.
        J Affect Disord. 2011; 133: 499-508
        • Quan L.
        • Cummings P.
        Characteristics of drowning by different age groups.
        Inj Prev. 2003; 9: 163-168
        • Hoek T.L.V.
        • Morrison L.J.
        • Shuster M.
        • Donnino M.
        • Sinz E.
        • Lavonas E.J.
        • et al.
        Part 12: cardiac arrest in special situations 2010 American Heart Association Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care.
        Circulation. 2010; 122 (S829-S61)
        • WHO
        Definition of an older or elderly person.
        • KMA, Korea Meteorological Administration
        • van Beeck E.F.
        • Branche C.
        • Szpilman D.
        • Modell J.H.
        • Bierens J.J.
        A new definition of drowning: towards documentation and prevention of a global public health problem.
        Bull World Health Organ. 2005; 83: 853-856
        • Orlowski J.P.
        • Abulleil M.M.
        • Phillips J.M.
        The hemodynamic and cardiovascular effects of near-drowning in hypotonic, isotonic, or hypertonic solutions.
        Ann Emerg Med. 1989; 18: 1044-1049
        • Grmec S.
        • Strnad M.
        • Podgorsek D.
        Comparison of the characteristics and outcome among patients suffering from out-of-hospital primary cardiac arrest and drowning victims in cardiac arrest.
        Int J Emerg Med. 2009; 2: 7-12
        • Szpilman D.
        • Bierens J.J.L.M.
        • Handley A.J.
        • Orlowski J.P.
        N Engl J Med. 2012; 366: 2102-2110
        • Pelkonen M.
        • Notkola I.L.
        • Lakka T.
        • Tukiainen H.O.
        • Kivinen P.
        • Nissinen A.
        Delaying decline in pulmonary function with physical activity: a 25-year follow-up.
        Am J Respir Crit Care Med. 2003; 168: 494-499
        • McKeever T.M.
        • Scrivener S.
        • Broadfield E.
        • Jones Z.
        • Britton J.
        • Lewis S.A.
        Prospective study of diet and decline in lung function in a general population.
        Am J Respir Crit Care Med. 2002; 165: 1299-1303
        • Goldspink D.F.
        Ageing and activity: their effects on the functional reserve capacities of the heart and vascular smooth and skeletal muscles.
        Ergonomics. 2005; 48: 1334-1351
        • Tanaka H.
        • Seals D.R.
        Endurance exercise performance in Masters athletes: age-associated changes and underlying physiological mechanisms.
        J Physiol. 2008; 586: 55-63
        • Kirkwood T.B.
        A systematic look at an old problem.
        Nature. 2008; 451: 644-647
        • Rockwood K.
        • Mitnitski A.
        Frailty defined by deficit accumulation and geriatric medicine defined by frailty.
        Clin Geriatr Med. 2011; 27: 17-26
        • Gomez C.R.
        • Boehmer E.D.
        • Kovacs E.J.
        The aging innate immune system.
        Curr Opin Immunol. 2005; 17: 457-462
        • Fillit H.M.
        Brocklehurst's textbook of geriatric medicine and gerontology.
        8th Edition. 2017
        • KOSIS
        Korean Statistical Information Service.
        (Available at)
        • Kyoung Hwan K.
        • lt, sup, gt, lt, sup
        • et al.
        The characteristics of elderly patients with suicide attempts: a comparative study with non-elderly patients.
        vol. 20. AGMR, 2016: 209-220
        • Jeon H.J.
        • Lee J.Y.
        • Lee Y.M.
        • Hong J.P.
        • Won S.H.
        • Cho S.J.
        • et al.
        Lifetime prevalence and correlates of suicidal ideation, plan, and single and multiple attempts in a Korean nationwide study.
        J Nerv Ment Dis. 2010; 198: 643-646
        • Oquendo M.A.
        • Kamali M.
        • Ellis S.P.
        • Grunebaum M.F.
        • Malone K.M.
        • Brodsky B.S.
        • et al.
        Adequacy of antidepressant treatment after discharge and the occurrence of suicidal acts in major depression: a prospective study.
        Am J Psychiatry. 2002; 159: 1746-1751
        • Sonnenberg C.M.
        • Beekman A.T.
        • Deeg D.J.
        • Tilburg V.
        Drug treatment in depressed elderly in the Dutch community.
        Int J Geriatr Psychiatry. 2003; 18: 99-104
        • Birrer R.B.
        • Vemuri S.P.
        Depression in later life: a diagnostic and therapeutic challenge.
        Am Fam Physician. 2004; 69: 2375-2382
        • Kim H.J.
        • Park J.C.
        Technical overview of suicide prevention structure on bridge.
        vol. 10. Korean Society of Civil Engineers, 2014: 1663-1664