Prognostic Value of the Szpilman Classification, Blood Lactate Levels, and Systemic Inflammatory Indices in Pediatric Drowning Patients

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In pediatric drowning cases, fatal outcomes are strongly predicted by the Szpilman classification, elevated lactate levels, and paradoxically lower baseline levels of systemic inflammation markers (SII, NLR, and PLR). Novelty: ClaimNovelty.CONTRADICTORY. Consensus alignment: ConsensusAlignment.CHALLENGES_CONSENSUS.

Zeynep Tanyeli; Utku Özer; Şener Çınıçev; Zeliha Akman Üsgüloğlu; Sinem Sarı Gökay

doi:10.1097/pec.0000000000003676

August 21, 2026Pediatric Emergency Care

Prognostic Value of the Szpilman Classification, Blood Lactate Levels, and Systemic Inflammatory Indices in Pediatric Drowning Patients

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Key Points

To evaluate the prognostic performance of the Szpilman classification, blood lactate levels, and systemic inflammatory indices (SII, NLR, PLR) in predicting mortality among pediatric drowning patients.
Retrospective analysis of pediatric drowning patients (N=91; 78 nonfatal and 13 fatal; mean age 9.6±5.0 years, 72.5% male) presenting to a tertiary pediatric emergency department between 2020 and 2024.
Receiver operating characteristic (ROC) analysis was conducted to measure the discriminatory accuracy of clinical scores, blood lactate, and baseline inflammatory markers (SII, NLR, PLR) for mortality.
All tested clinical and laboratory markers significantly predicted fatal outcomes (P<0.001), with the highest accuracy achieved by the Szpilman classification (AUC: 0.978), PLR (AUC: 0.957), and lactate levels (AUC: 0.935).
Systemic inflammatory markers showed strong prognostic utility (SII AUC: 0.843; NLR AUC: 0.817), with fatal drowning uniquely associated with significantly lower baseline values of PLR, SII, and NLR.

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Implication

Retrospective study reveals that Szpilman score, lactate, and low inflammatory indices predict mortality in pediatric drowning, indicating severe acute immunologic and metabolic collapse.

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Tanyeli et al. (2026) studied this question.

synapsesocial.com/papers/6a8aae337677a3411444700f https://doi.org/10.1097/pec.0000000000003676

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Prognostic Value of the Szpilman Classification, Blood Lactate Levels, and Systemic Inflammatory Indices in Pediatric Drowning Patients

Key Points

No abstract yet

Implication

Discussion

Cite This Study

Prognostic Value of the Szpilman Classification, Blood Lactate Levels, and Systemic Inflammatory Indices in Pediatric Drowning Patients

Key Points

No abstract yet

Implication

Discussion

Cite This Study

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