Predictors of Mortality in Adult Seawater Drowning Patients: A Retrospective Analysis of Arterial Blood Gas, Inflammatory Indices, and Radiological Findings Yetişkin Tuzlu Su Boğulması Hastalarında Mortalite Belirleyicileri: Arteriyel Kan Gazı, Enflamatuar İndeksler ve Radyolojik Bulguların Retrospektif Analizi

Yurttaş A., Çelik D., Lakadamyali H., BULUT S., URSAVAŞ A.

Journal of Uludag University Medical Faculty, cilt.52, 2026 (Scopus)

Özet

This study sought to identify independent predictors of mortality in patients with seawater drowning and to evaluate the prognostic performance of arterial blood gas parameters and inflammatory indices using receiver operating characteristic (ROC) curve analysis. Medical records of a total of 51 drowning cases (34 males, 17 females; mean age 48.8 years) were retrospectively reviewed. Age, sex, ethanol level, complete blood count, biochemical parameters, arterial blood gas parameters, lung imaging findings, and clinical outcomes were analyzed. The cut-off values of parameters with predictive values for mortality were determined using receiver operating characteristic (ROC) curve analysis. The overall mortality rate was 45% (23/51). The main factors significantly associated with mortality were advanced age, cardiac arrest, need for intensive care, elevated troponin levels (>11 ng/L), and severe metabolic acidosis. Bicarbonate <20.1 mmol/L (AUC: 0.95), base deficit <−8.15 mmol/L (AUC: 0.87), lactate >5.9 mmol/L (AUC: 0.90), and arterial pH <7.22 (AUC: 0.97) demonstrated the highest predictive value for mortality. Mortality following drowning can be predicted with high accuracy at an early stage using simple and widely available laboratory tests and clinical assessments. Lymphocyte count, troponin levels, and arterial blood gas analyses play a critical role in triage and in determining aggressive treatment strategies.