Despite advances in the prevention and management of drowning patients [1], drowning remains a global public health concern resulting in >372,000 deaths worldwide [2]. Critically ill drowning patients may experience Drowning-Associated Cardiac Arrest (DACA) due to hypoxia caused by inhalation of water into the lungs [3]. The occurrence of DACA has been described as having a major influence on prognosis with survival rates ranging from 43% to 54% [4,5]. The uncertain prognosis of these patients is mainly promoted by brain hypoxic injury and ischaemia-reperfusion phenomenon. Management of DACA is standardized and mainly based on symptomatic measures including bystanders' cardiopulmonary resuscitation [6]. However, beyond the initial management of these patients, outcomes may vary depending on several factors such as the duration as well as the circumstances of the drowning process [[7], [8], [9]].

Although early accurate assessment of prognosis to identify patients that would benefit from intensive care is necessary, prognostication tools for survival of DACA patients remain poorly explored. Therefore, we sought to develop a clinico-biological score to predict poor outcomes in patients admitted to intensive care units (ICUs) after the occurrence of a DACA.