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. 2024 Jan 2;16(1):6.
doi: 10.1186/s13102-023-00799-w.

Hypothesized mechanisms of death in swimming: a systematic review

Yunheng Yao  1   2 , Michael A DiNenna  3 , Lili Chen  1   2 , Shirong Jin  1   2 , Sixian He  1   2 , Jinshen He  4
Affiliations

Hypothesized mechanisms of death in swimming: a systematic review

Yunheng Yao et al. BMC Sports Sci Med Rehabil. .

Abstract

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.

Keywords: Cardiovascular disease; Death; Drowning; Mechanism; Swimming.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) flow diagram
Fig. 2
Fig. 2
Mechanisms of swimming-related death
See this image and copyright information in PMC

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