Outcomes in 886 Critically Ill Patients After Near-Hanging Injury

Charentenay, Louise de; Schnell, Guillaume; Pichon, Nicolas; Schenck, Maleka; Cronier, Pierrick; Parratte, Sébastien; Lascarrou, Jean Baptiste; Rossignol, Thomas; Lesieur, Olivier; Argaud, Laurent; Colin, Gwenhaël; Cholley, Bernard; Quenot, Jean‐Pierre; Merdji, Hamid; Silva, Stein; Piagnerelli, Michaël; Chelly, Jonathan; Salvetti, Marie; Couraud, Segolene; Deye, Nicolas; Déserts, Marc Danguy des; Paul, Marine; Thiéry, Guillaume; Simon, Marc A.; Martin, C.; Vincent, François; Das, Vincent; Jacq, Gwenaëlle; Jacobs, Frédéric; Soummer, Alexis; Mayaux, Julien; Beuret, Pascal; Ouchenir, Abdelkader; Durant, Caroline; Darmon, Michaël; Azoulay, Élie; Sauneuf, Bertrand; Daubin, Cédric; Biard, Lucie; Cariou, Alain; Geeraerts, Thomas; Legriel, Stéphane; Girard, Nicolas; Cour, Martin; Prisacariu, Adriaan; Dargent, Auguste; Meziani, Ferhat; Baudic, Thibaut; Vignon, Philippe; Belony, Candice; Leparq, Charlene; Carré, Cécile; Moriss, Pauline; Noel, Emmanuelle; Cavelot, Sébastien; Bachelet, Delphine; Roux, Quentin de; Resche‐Rigon, Matthieu; Guitton, Christophe; Mégarbane, Bruno; Cerf, Charles; Demoule, Alexandre; Kalfon, Pierre

doi:10.1016/j.chest.2020.07.064

Cited by 12 publications

(7 citation statements)

References 28 publications

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“…Studies from other countries reported alcohol abuse in 22 and 26% of the study population. 7 , 11 Our study suggests that substance abuse and family disputes may contribute to suicide among young and middle-aged individuals. The potential impact of alcohol addiction on family dynamics and the risk of domestic violence should be recognized as significant risk factors for suicide.…”

Section: Discussionmentioning

confidence: 72%

“… 6 Low Glasgow Coma Scale (GCS), hypotension, hypoxic brain injury, pulmonary edema, high Acute Physiology and Chronic Health Evaluation - II (APACHE-II) scores, the requirement of vasopressor therapy, hanging-induced cardiac arrest, and hyperglycemia at admission were the factors associated with the poor prognosis of near-hanging patients. 6 , 7 There are very few Indian studies on near-hanging patients and the literature on steroid therapy in near-hanging is scarce. Hence, this study was designed to evaluate the clinical profile, treatment details, and predictors of mortality in near-hanging patients.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Profile, Corticosteroid Usage and Predictors of Mortality in Near-hanging Patients: A Five-year, Single-center Retrospective Study

Ramadoss,

Sekar,

Rameesh

et al. 2023

Indian Journal of Critical Care Medicine

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A bstract Background Hanging is the most common method of suicide in India. When near-hanging patients reach the hospital for treatment, their neurological outcome ranges from full recovery to severe neurological impairment or death. This study looked at the clinical profile, usage of corticosteroids and predictors of mortality in near-hanging patients. Materials and methods This retrospective study was conducted from May 2017 to April 2022. Demographic, clinical, and treatment details were collected from case records. Neurological outcome at discharge was assessed using the Glasgow Outcome Scale (GOS). Results The study involved 323 patients, 60% of men with a median (interquartile range) age of 30 (20–39). At the time of admission, the Glasgow Coma Scale (GCS) ≤8 in 110 (34%) patients, hypotension was present in 43 (13.3%) of patients, and 21 (6.5%) had hanging-induced cardiac arrest. About 101 patients required intensive care unit care. Corticosteroid therapy was given to 219 patients (67.8%) as part of anti-cerebral edema measures. Good neurological recovery was found (GOS-5) in 84.2% of patients, and the death rate (GOS-1) was 9.3%. Univariate logistic regression showed that usage of corticosteroids is significantly associated with poor survival ( p < 0.02, odds ratio 4.7). In the multivariable logistic regression analysis, GCS ≤8, hypotension, need for intensive care, hanging-induced cardiac arrest, aspiration pneumonia, and severe cerebral edema were found to be significantly associated with mortality. Conclusion The majority of near-hanging patients had a good neurological recovery. Corticosteroids were used in two-thirds of the study population. There were multiple variables associated with mortality. How to cite this article Ramadoss R, Sekar D, Rameesh M, Saibaba J, Raman D. Clinical Profile, Corticosteroid Usage and Predictors of Mortality in Near-hanging Patients: A Five-year, Single-center Retrospective Study. Indian J Crit Care Med 2023;27(6):403–410.

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Section: Discussionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Clinical Profile, Corticosteroid Usage and Predictors of Mortality in Near-hanging Patients: A Five-year, Single-center Retrospective Study

Ramadoss,

Sekar,

Rameesh

et al. 2023

Indian Journal of Critical Care Medicine

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“…The ineffectiveness of TTM may be related to the polarization of prognosis (either those who die or those with good neurological outcomes) depending on the initial state of the patient [ 9 ]. A single-center study identified the clinical factors associated with improved neurological outcomes in children after near-hanging and showed that patients with poor outcomes had lower blood pH (6.9 vs. 7.3) and lower GCS scores (3T vs. 14) [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

A Child With a Glasgow Coma Scale Score of 4 After Near-Hanging: A Case Report on Treatment Without Intubation and Targeted Temperature Management

Kanno¹,

Yamagami²,

Hanada³

et al. 2023

Cureus

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While prehospital medical interventions are evolving and improving survival rates, the evidence for adequate early prognostic assessment is often insufficient. A 12-year-old Japanese child was found hanging on the roof of his home. After being rescued by his mother, he was transported by an ambulance and a rapid response car (RRC) with doctors, nurses, and paramedics on board, and admitted to our hospital. His initial Glasgow Coma Scale score in the RRC was 4. Although he did not undergo intubation and targeted temperature management (TTM), he had no neurological sequelae upon discharge. To the best of our knowledge, this report is the first to describe the case of a child with a decreased level of consciousness after near-hanging, who was treated without intubation and TTM.

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“…As previously described ( 17 ), we used a standardized form for each patient to collect demographic data, medical history, and the characteristics of the hanging-induced CA according to the Utstein-style guidelines ( 19 ).…”

Section: Methodsmentioning

confidence: 99%

“…One of the main determinants of mortality and residual neurological impairment is the occurrence of hanging-induced CA ( 4 , 7 , 9 , 11 , 14 , 16 ). In a retrospective study of 886 ICU patients with hanging injuries, 450 patients had cardiac arrest, which was strongly associated with mortality (OR 19.50; 95%CI, 7.21–60.90) ( 17 ). This high rate of mortality is probably ascribable to CA-related systemic ischaemia-reperfusion syndrome with initial cardiogenic, vasoplegic hemodynamic failure, and anoxic brain injury ( 18 ).…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and outcome predictors in 450 patients with hanging-induced cardiac arrest: a retrospective study

Salvetti,

Schnell,

Pichon

et al. 2023

Front. Neurol.

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BackgroundCardiac arrest is the most life-threatening complication of attempted suicide by hanging. However, data are scarce on its characteristics and outcome predictors.MethodsThis retrospective observational multicentre study in 31 hospitals included consecutive adults admitted after cardiac arrest induced by suicidal hanging. Factors associated with in-hospital mortality were identified by multivariate logistic regression with multiple imputations for missing data and adjusted to the temporal trends over the study period.ResultsOf 450 patients (350 men, median age, 43 [34–52] years), 305 (68%) had a psychiatric history, and 31 (6.9%) attempted hanging while hospitalized. The median time from unhanging to cardiopulmonary resuscitation was 0 [0–5] min, and the median time to return of spontaneous circulation (ROSC) was 20 [10–30] min. Seventy-nine (18%) patients survived to hospital discharge. Three variables were independently associated with higher in-hospital mortality: time from collapse or unhanging to ROSC>20 min (odds ratio [OR], 4.71; 95% confidence intervals [95%CIs], 2.02–10.96; p = 0.0004); glycaemia >1.4 g/L at admission (OR, 6.38; 95%CI, 2.60–15.66; p < 0.0001); and lactate >3.5 mmol/L at admission (OR, 6.08; 95%CI, 1.71–21.06; p = 0.005). A Glasgow Coma Scale (GCS) score of >5 at admission was associated with lower in-hospital mortality (OR, 0.009; 95%CI, 0.02–0.37; p = 0.0009).ConclusionIn patients with hanging-induced cardiac arrest, time from collapse or unhanging to return of spontaneous circulation, glycaemia, arterial lactate, and coma depth at admission were independently associated with survival to hospital discharge. Knowledge of these risk factors may help guide treatment decisions in these patients at high risk of hospital mortality.

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Outcomes in 886 Critically Ill Patients After Near-Hanging Injury

Cited by 12 publications

References 28 publications

Clinical Profile, Corticosteroid Usage and Predictors of Mortality in Near-hanging Patients: A Five-year, Single-center Retrospective Study

Clinical Profile, Corticosteroid Usage and Predictors of Mortality in Near-hanging Patients: A Five-year, Single-center Retrospective Study

A Child With a Glasgow Coma Scale Score of 4 After Near-Hanging: A Case Report on Treatment Without Intubation and Targeted Temperature Management

Epidemiology and outcome predictors in 450 patients with hanging-induced cardiac arrest: a retrospective study

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