Table 2

Relevant papers

Author, date and countryPatient groupStudy type (level of evidence)OutcomesKey resultsStudy weaknesses
Rafaat KT et al
1 2008
USA
156 children admitted to Rady’s Children’s Hospital San Diego with a diagnosis of drowning between January 1986 and April 2006 with no evidence of trauma, who received a cranial CT within 24 hours.Retrospective chart review.Abnormal cranial CT scan.104 (82%) had normal a CT scan. 24 (15%) had abnormalities on later scans. No patient with a GCS>4 had an abnormal CT at any time. Presenting GCS was significantly lower in those presenting with abnormal vs normal head CT (p=0.001). All 28 patients with an initial abnormal CT died.Retrospective series. One Centre. Therapy not controlled or recorded.
Romano C et al 2 1993
Canada
19 near-drowned children admitted to the Children’s Hospital of Western Ontario between 1983 and 1991.Retrospective chart review.Abnormal cranial CT scan compared with clinical outcome15 received a cranial CT scan within 36 hours. 12 (80%) had a normal scan. The clinical outcome of these patients varied between full recovery, long-term neurological deficit, and death. Of the three patients with abnormal CT, all died.Retrospective series from one centre with a small number of patients. Therapy not controlled or recorded.
Taylor SB et al 3 1985
USA
17 children admitted to either the University Hospital Miami or the Children’s Memorial Hospital Chicago for near drowning, who had a cranial CT scan within 24 hours of immersion incident between 1978 and 1984.Retrospective chart review.Abnormal cranial CT compared with clinical outcome.12 had normal CT scans. The clinical outcome in these patients was variable. Of the five with abnormal CT scans, four died (80%).Retrospective series with a small number of patients. Therapy not controlled or recorded.