Epidemiological and Clinical Characteristics of Seawater Drowning Cases in Sinop, a Turkish Coastal City: A 13-Year Retrospective Study

Background: Drowning is a significant public health issue, particularly in coastal regions like Sinop, Turkey, where seasonal variations contribute to a high incidence of cases. This study aims to analyze the demographic, clinical, and outcome characteristics of drowning patients admitted to the Emergency Department (ED) to inform prevention strategies and improve emergency response. Methods: A retrospective, cross-sectional study was conducted on all patients admitted to the regional referral ED due to seawater drowning between July 2011 and July 2024. Demographic characteristics, clinical parameters, and outcomes were retrieved from institutional and national health record systems. Descriptive statistical analyses were performed. Missing variables were retained as “no data” without imputation. Results: A total of 198 patients were included in the study, of whom 69.2% (n = 137) were male and 30.8% (n = 61) were female. The mean age was 29.63 ± 19.27 years. Most incidents occurred during the summer, with July (42.4%) and August (40.4%) accounting for the majority. Cardiopulmonary resuscitation (CPR) was performed in 17.7% of patients, mostly initiated by EMS and continued in the ED. Intubation was performed in 19.7% of patients in the ED and in 1.0% by EMS. Trauma was documented in 7.1% of patients; among these, the most commonly affected regions were the extremities (50.0%) and the head (35.7%). Laboratory analysis showed elevated lactate levels (mean: 8.6 mmol/L) and reduced pH (mean: 7.16). Upon admission, 72.7% had a GCS of 13–15 (mild/no impairment), 19.2% had severe impairment (GCS 3–8), and 1.5% moderate (GCS 9–12). The Szpilman score indicated mild symptoms in 37.9%, moderate in 19.7%, and severe in 17.7%. The overall mortality was 19.7%, and 22.2% of patients required admission to the intensive care unit (ICU). Notably, 35.9% of all fatal cases (n = 14) involved individuals who drowned while attempting to rescue others. Conclusions: Drowning imposes a substantial burden in coastal regions, disproportionately affecting young males during the summer. This study highlights the need for enhanced emergency preparedness, timely prehospital resuscitation, and structured clinical response pathways. These findings contribute valuable insight for developing regional strategies to mitigate preventable drowning outcomes. Trial registration: Not applicable. This study is a retrospective observational analysis and was not registered as a clinical trial.