Can clinical variables at admission influence the outcome in patients with suicidal hanging: a prospective study

Abstract

INTRODUCTIONThere is worldwide concern over an observed rise in the rate of suicide, especially among young adults. [1][2][3] Hanging is considered one of the commonest way of committing suicide next only to poisoning in India. 4 Hanging victims present to emergency department of hospitals and most of them need specialized care in intensive care units. Unfortunately, suicidal hanging is one medical emergency about which there is very little information available in medical literature. Though numbers of reports about post-mortem findings in nearhanging are available, published data on clinical aspects of the problem and means of prognostication to guide the clinician are scanty. Also there are only very few studies available relating the risk factors with the outcome of suicidal-hanging patients. ABSTRACT Background:Hanging is considered one of the commonest ways of committing suicide, next only to poisoning in India. Very little information is only available in medical literature about prognosticating factors in suicidal hanging. Analysis of various parameters at the time of admission and their association with outcome can help in risk stratification as well as prognostication. Methods: Four variables namely GCS, Mean arterial pressure, Oxygen saturation and capillary blood sugar were recorded at the time of admission. All patients received standard intensive care throughout the stay in ICU as demanded. Outcome was divided in to two groups, Good and poor. Good outcome was defined as complete neurological recovery at the time of discharge and poor outcome was defined as either death during hospital stay or persistent neurological deficit which did not improve even after a period of three months follow up. Results: Total of forty patients was included in the study. Male patients outnumbered the number of female patients admitted with suicidal hanging. Irrespective of the gender more patients belonged to the third decade of. Out of forty, thirty patients showed complete neurological recovery, five patients had persistent neurological deficit even after three months and five patients died during the course of the treatment. Conclusions: The present study confirms the age and sex distribution of suicidal hanging which is more common amongst male gender and 3rd followed by 4th decade of life in both sex. Admission parameters like GCS≤8, MAP < 60 mmHg and CBG >180mg % can be considered as risk factors for poor outcome.