Analysis of predictive factors in the assessment of warm-water near-drowning in children.

The records of 42 children hospitalized after a serious fresh-water accident were studied retrospectively. Nine variables thought to be indicative of neurologic outcome in near-drowned patients were analyzed by means of a stepwise discriminant function procedure. The presence of coma and fixed and dilated pupils on examination in the emergency room perfectly predicted those patients who would die (24%) or sustain severe and permanent brain damage (16% of the survivors). All dead or badly brain-damaged patients drowned or nearly drowned in warm water (greater than 20 degrees C). Easily obtained prognostic neurologic findings may be important in assessing the efficacy of resuscitation measures in pediatric near-drowning victims, particularly those who were immersed in warm water.