Morbidity and mortality of pediatric drowning in Qatar: an epidemiological analysis of submersion encounters at a level I pediatric trauma center

BACKGROUND:
Pediatric drowning is a preventable cause of mortality and morbidity worldwide, yet detailed outcome data from the Gulf region remain scarce.


OBJECTIVES:
To describe the epidemiology, clinical characteristics, neurological outcomes, and predictors of poor prognosis in pediatric drowning cases in Qatar.


DESIGN:
Retrospective observational study


SETTING:
Sidra Medicine, the only level I pediatric trauma and tertiary care center in Qatar.


PATIENTS AND METHODS:
Records of all pediatric drowning cases (0–18 years old) over a 6.5-year period from May 2018 to November 2024 were reviewed. Data included demographics, incident details, prehospital interventions, clinical presentation, laboratory findings, and outcomes using the Pediatric Cerebral Performance Category Scale (PCPCS). Predictors of mortality were analyzed.


MAIN OUTCOME MEASURES:
Neurological status at discharge (PCPCS), mortality, and associations between clinical variables and outcome.


SAMPLE SIZE:
225 pediatric drowning cases


RESULTS:
Median age was 3.0 years (IQR 2.0–6.0), and 65.3% were male. Incidents occurred in freshwater (76.4% [n=172]), predominantly residential pools (67.6% [n=152]). Mortality was 12.0% (n=27). Good neurological outcomes at discharge (PCPCS=1) occurred in 81.3% (n=183) of children, while 2.7% (n=6) survived with neurological disability (PCPCS 3–5). Prolonged submersion duration and lower initial arterial pH were independently associated with mortality. CPR duration and lactate were associated with mortality in univariate analysis but lost statistical significance after adjustment.


CONCLUSION:
Pediatric drowning in Qatar predominantly involves preschool-aged boys in residential pools. Mortality is strongly associated with prolonged submersion and severe acidosis at presentation. Prevention strategies should prioritize pool safety regulation, supervision, and early rescue to reduce hypoxic injury.


LIMITATIONS:
Retrospective single-center design with incomplete prehospital details and no long-term follow-up.