Predictors of functional outcome after hanging injury

Abstract

PurposeSuicide becomes a serious problem in today's society and hanging is a common method of suicide. We want to find the factors which can predict the final functional outcomes of these cases.MethodsAll patients who presented to Accident and Emergency Department (ED) of the National Cheng Kung University Hospital from 1st January 2005 to 31th December 2013 with a hanging injury were included in this study. All cases were divided into good outcome group and bad outcome group according to Glasgow Outcome Scale (GOS). Data was analyzed by Mann-Whitney test and chi-square test.ResultsGlasgow Coma Scale (GCS) < 3, pupil dilation and no pupillary light reflex both at the scene and ED were the factors to indicate poor functional outcome. Out-hospital cardiac arrest (OHCA), acidosis (pH < 7.2) and the need for intubation once arriving at ED were also related to poor functional outcome. OHCA cases all had poor functional outcome.ConclusionGCS, pupil size, pupillary light reflex, OHCA and acidosis are useful as prognostic factors. GCS = 3 lead to a very poor outcome. However, the functional outcome seems good in patients with GCS>3. There parameters can help to predict the outcome before treatment.

An Evaluation of the Effect of the COVID-19 Pandemic Lockdown on Hanging Cases

“…Incompatible with our findings (n=10, 4.1%), in a study that investigated 13 near-hanging cases, it was reported that five patients (38%) needed intubation [12]. In another study involving hanging cases admitted over the course of eight years, it was reported that 28 patients (68.2%) needed intubation [15].…”

Hangings attended by emergency medical services: a scoping review

“…Once duplicates had been removed, 30 full-text papers were reviewed. Thirteen papers ( Alqahtani et al, 2019 ; Atreya & Kanchan, 2015 ; Davies et al, 2011 ; Deasy et al, 2011 , 2013 ; Escutinaire et al, 2019 ; Kao & Hsu, 2018 ; Kim et al, 2016 ; Martin et al, 2005 ; Matsuyama et al, 2004 , 2016 ; Rehn et al, 2018 ; Wee et al, 2012 ) were included in the review based on the initial papers. A further three ( Boots et al, 2006 ; Hanna, 2004 ; Penney et al, 2002 ) were included based on papers identified in the reference list searches.…”

“…Many papers considered prognostication in hanging patients and how decisions about resuscitation could be supported and informed. Indicators of a poor outcome included: lack of bystander CPR (BCPR) ( Deasy et al, 2013 ; Wee et al, 2012 ); circumferential ligature marks ( Matsuyama et al, 2004 ); Glasgow Coma Score (GCS) of three either at the scene or at Emergency Department (ED) arrival ( Boots et al, 2006 ; Kao & Hsu, 2018 ); asystole at the scene ( Escutinare et al, 2019 ); pupil dilation and lack of responsiveness ( Kao & Hsu, 2018 ). Contact with the ground ( Boots et al, 2006 ) and hanging time <5 minutes were associated with positive outcomes, whereas >30 minutes hanging was associated with a negative outcome ( Matsuyama et al, 2004 ).…”

Hanging-related injury in Pietermaritzburg, South Africa

“…It is more prevalent in men than in women and is often associated with the consumption of alcohol. [5] There is a high prevalence of associated comorbidities among hanging victims, a significant need for emergency intubation (16.2%) and admission to the ICU (4.5%), and a 2.5% mortality rate. [5,6] Self-inflicted hanging exerts prolonged pressure on the neck and may cause trauma to the cervical spine and aerodigestive tract, and global ischaemia of both cerebral hemispheres.…”

“…[5] There is a high prevalence of associated comorbidities among hanging victims, a significant need for emergency intubation (16.2%) and admission to the ICU (4.5%), and a 2.5% mortality rate. [5,6] Self-inflicted hanging exerts prolonged pressure on the neck and may cause trauma to the cervical spine and aerodigestive tract, and global ischaemia of both cerebral hemispheres. [6] In our series, hanging caused cervical spine injury in 6.4% of patients, and aerodigestive tract injury in ~2.0 %.…”