Near hanging: Early intervention can save lives

Gandhi, Ritika; Taneja, Neeta; Mazumder, Paritosh

doi:10.4103/0019-5049.84863

Cited by 25 publications

(32 citation statements)

References 9 publications

(26 reference statements)

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“…10 The pathophysiological basis of adverse outcome in hanging has been attributed to various factors like cerebral hypoxia, laryngeal oedema, airway obstruction, high vagal tone secondary to carotid sinus stimulation injuries secondary to local structures like thyroid cartilage/hyoid bone fracture/laryngeal rupture, secondary pulmonary complications (aspiration pneumonia, development of adult respiratory distress, negative pressure, pulmonary oedema or secondary cerebral injury due to cerebral oedema etc. 6,7 As in every other study, majority of patients who attempt suicidal hanging are invariably male and young, the same pattern continues in our study also. Out of forty patients, 27 (67.5%) patients belonged to male gender and twenty patients (50%) belong to age group (in both sexes) of twenty one to thirty years.…”

Section: Discussionsupporting

confidence: 73%

“…The overall survival rate without any neurological deficit in our study is 75% which is well within the range quoted in earlier studies. 7 As in any studies involving hanging, the less number of patients in this study is the major limitation.…”

Section: Discussionmentioning

confidence: 99%

“…7 Out of probable factors that can predict the outcome, the well-studied and nearly confirmed predictor is duration of hanging time. Though the exact duration of hanging can never be mentioned accurately-for obvious reasons, it has been shown to be closely related to mortality.…”

Section: Discussionmentioning

confidence: 99%

“…5 The term near hanging is reserved for victims who have survived the hanging injury and reaches the hospital. 6,7 Death in suicidal hanging usually results from asphyxial cerebral injury which is different from judicial hanging where death occurs due to cervical spine injury. 8 Mechanism of asphyxia is considered to be because of stagnant hypoxia resulting from jugular venous obstruction due to compression of the soft tissues of the neck.…”

Section: Discussionmentioning

confidence: 99%

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

Raajesh

Shanmugam

2016

Int J Adv Med

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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.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Raajesh

Shanmugam

2016

Int J Adv Med

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“…The most effective factors on survival are the compression of low body weight and neck structures in near hanging [4]. Some factors such as Sistolik blood pressure < 90, Glaskow koma skoru (GCS) < 8, anoxic brain injury on CT scan, and Injury Severity Scor > 15 were found to be significantly associated with mortality in near-hanging [5].…”

Section: Introductionmentioning

confidence: 99%

The Effective Factors on Survival in Near-Hanging

2015

JACCOA

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Aim: Neck hanging is one of the most lethal suicide methods. The morbidity and mortality due to hanging is usually associated with neck's structure injury attached to a fall from height, venous obstruction and cerebral hypoxia time. Mortality is usually caused by respiratory failure in patients who recovered from hanging. In this study, we aimed to investigate effective factors on mortality in cases of neck hanging. Materials and Methods:Socio-demographic data of 43 out of 2006-2013 patients brought to our hospital because of neck hanging were analyzed retrospectively. The first arrival time of clinical signs of the patient, laboratory findings and complications due to hanging were recorded. The effects of these findings on mortality are examined.Results: 35% of the 43 patients were included in the study were female gender. The mean age of the patients was 21.4±6.8 minutes. The estimated time was found to be 25±12 (minimum-maximum 3-60) minutes. 26 patients (68.4%) were lost their life. The Glasgow coma score of the majority of patients who died was less than 7. Among the most common complications associated with hanging, laryngeal edema(60%) was observed. Among the most common complications during the intensive care, pulmonary infection (18.5%) was developed. Conclusion:The most important factor in terms of effectiveness over mortality for hanging were observed to be time increment of hanging and low Glasgow coma score. We recommended that the cases of near hanging should be aggressively resuscitated and treated regardless of their bad initial findings. Keywords: IntroductionHanging is the most mortal suicide methods after the gunshot wounds in many countries [1]. In hanging the morbidity and mortality occur due to venous obstruction and cerebral hypoxia, laryngeal edema and delayed airway obstruction, increased vagal tone, injury of neck structures (thyroid cartilage/hyoid bone fracture/laryngeal rupture) pulmonary complications (aspiration pneumonia, development of adult respiratory distress syndrome, pulmonary oedema secondary to negative intrathoracic pressure due to attempted inspiration in upper airway obstruction or centrally mediated sympathetic discharge leading to generalized vasoconstriction), subarachnoid hemorrhage, hyperthermia, status epileptics [2].Despite hanging has high fatality rate, survival is possible even after prolonged periods of suspension, and the term near hanging refers to patients who initially survive the attempt [3]. The most effective factors on survival are the compression of low body weight and neck structures in near hanging [4]. Some factors such as Sistolik blood pressure < 90, Glaskow koma skoru (GCS) < 8, anoxic brain injury on CT scan, and Injury Severity Scor > 15 were found to be significantly associated with mortality in near-hanging [5]. In the present study we aimed to investigate the prognostic factors on the survival rate of the near hanging patients treated in intensive care unit (ICU). Material and MethodIn this study, patients diagnosed and treated be...

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