Pre-Existing Medical Conditions: A Systematic Literature Review of a Silent Contributor to Adult Drowning

Peden, Amy E.; Taylor, Danielle Horton; Franklin, Richard C.

doi:10.3390/ijerph19148863

Cited by 9 publications

(2 citation statements)

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“…Cardiac arrhythmias, especially of genetical origin, may explain deaths in water occurring without an apparent cause (Lunetta, 2022). In a systematic literature review, Peden et al (2022) concluded that drowning occurs in people with existing medical conditions, yet relatively few studies have documented the risk. Diseases of the nervous system (39%), mental and behavioral conditions (37%) and diseases of the circulatory system (30%) were the most common categories of preexisting medical conditions.…”

Section: Cause and Manner Of Deathmentioning

confidence: 99%

Role of postmortem toxicology in drowning investigations

Ojanperä,

Kriikku

2023

WIREs Forensic Science

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Drowning is the third most common cause of unintentional injury death worldwide. In forensic medicine, drowning refers to an event in which the victim dies due to liquid penetrating into the airways or due to submersion in a liquid. Medico‐legal examination of bodies found in water is a challenging task. Establishing proper cause and manner of death requires the joint efforts of the police, medical examiner, and representatives of postmortem toxicology. Information of the circumstances, the victim's individual characteristics and medical background, together with postmortem findings is required. The presence of alcohol and drugs revealed by postmortem toxicology can give insight into the decedent's medical history, drug abuse history, and possible impairment at the time of death. There is ample epidemiological research indicating that alcohol is the most important single contributing factor for fatal drowning, while hypno‐sedative medicines and illicit drugs, especially amphetamines, also appear to pose a risk. Evidence shows that alcohol can be produced postmortem in a submerged body by microbial contamination and fermentation, and this phenomenon is even more significant the higher the water temperature and the longer the submersion time. The reliability of the blood alcohol concentration obtained can be verified in many ways, for example by comparing the ratios of blood, vitreous and urine alcohol concentrations with reference values, or by testing for non‐oxidative ethanol metabolites, the presence of which suggests antemortem alcohol ingestion. Compared to alcohol postmortem changes, very little is known about the long‐term stability of drugs in bodies found in water.This article is categorized under: Toxicology > Analytical Toxicology > Post‐Mortem

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Section: Cause and Manner Of Deathmentioning

confidence: 99%

Role of postmortem toxicology in drowning investigations

Ojanperä,

Kriikku

2023

WIREs Forensic Science

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“…But this systematic review concluded that limited evidence does not support these as common death mechanisms. A new study classified the pre-existing medical conditions of fatal or non-fatal drowning as diseases of the nervous system, mental and behavioral conditions and diseases of the circulatory system [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Hypothesized mechanisms of death in swimming: a systematic review

Yao,

DiNenna,

Chen

et al. 2024

BMC Sports Sci Med Rehabil

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Background The study aims to update the specific classification of mechanisms of death in swimming and to demonstrate these categories are reasonable, by analyzing more characteristics of death cases, evaluating the available evidence and determining their quality. Methods Original articles were queried from PubMed, Web of Science, Embase databases, Cochrane Library, and Scopus. Included studies, which were evaluated as level 4 evidence or higher according to the Oxford Centre for Evidence-Based Medicine, discussed hypothesized mechanisms of death in swimming. Parameters analyzed in this study included decedents’ characteristics, outcome measures, findings, methodological index for non-randomized studies (MINORS), and critical evaluation of each study classified by death mechanism. Results A total of twenty-five studies were included for further analysis: fourteen were associated with cardiovascular diseases, two were about cerebrovascular diseases, two contained respiratory diseases, seven were about hazardous conditions and three contained other drownings, which provided evidence for mechanisms of death. Conclusions It is found that cardiovascular disease is the main cause or contributing factor of death in swimming. Respiratory diseases and cerebrovascular diseases are difficult to be definitive mechanism categories due to insufficient evidence. Hazardous conditions appear to be one of the possible risk factors because there are more cases of deaths from unsafe environments in swimming, but further statistics and research are still needed to support this view. Our study may have important implications for developing potential prevention strategies for sports and exercise medicine. Trial registration PROSPERO ID (CRD42021267330). Registered Aug 13th 2021.

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