Neurologic outcome of comatose survivors after hanging: a retrospective multicenter study
Affiliations
- Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea
Affiliations
- Department of Emergency Medicine, Inje University Busan Paik Hospital, Busan, Korea
Affiliations
- Department of Emergency Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
Affiliations
- Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea
Affiliations
- Department of Emergency Medicine, Bucheon Hospital of Soonchunhyang University, Bucheon, Korea
Affiliations
- Department of Emergency Medicine, Hanyang University College of Medicine, Seoul, Korea
Affiliations
- Department of Emergency Medicine, Konyang University College of Medicine, Daejeon, Korea
Affiliations
- Department of Emergency Medicine, College of Medicine, Chungnam National University, Daejeon, Korea
Affiliations
- Department of Emergency Medicine, Konkuk University School of Medicine, Seoul, Korea
Affiliations
- Department of Emergency Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
Affiliations
- Department of Emergency Medicine, Chungbuk National University Hospital, Cheongju, Korea
Affiliations
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea
Affiliations
- Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea
Correspondence
- Corresponding author at: Department of Emergency Medicine, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul, Korea 06273. Tel.: +82 2 2019 3030; fax: +82 2 2019 4820.
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Correspondence information about the author MD Sung Phil ChungAffiliations
- Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea
Correspondence
- Corresponding author at: Department of Emergency Medicine, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul, Korea 06273. Tel.: +82 2 2019 3030; fax: +82 2 2019 4820.
Email the author MD Sung Phil Chung
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Fig. 1
The number of hanging patients and neurologic outcome
ED, emergency department; DOA, death on arrival; CPR, cardiopulmonary resuscitation; CPC, cerebral performance category.
Abstract
Purpose
The aim of this study is to identify the neurologic outcome of hanging patients and prognostic factors.
Materials and Methods
We retrospectively investigated comatose hanging patients who arrived at the emergency departments (EDs) of twelve academic tertiary care centers during a period of seven years (2006–2012). Patients were analyzed separately according to whether out-of-hospital cardiac arrest (OHCA) occurred or not. The neurologic outcome was evaluated using the Cerebral Performance Category (CPC) at the time of hospital discharge.
Results
A total of 1118 patients were admitted to the ED after hanging attempts. There were 159 comatose patients who did not experience OHCA. Twelve (7.5%) of 159 patients were discharged from the hospital with a poor neurologic outcome (CPC 3–5). These 12 patients received only conservative management without therapeutic hypothermia. On multivariate logistic regression analysis, mental state upon ED arrival and arterial pH were predicting factors for poor prognosis. One hundred twenty-one patients suffered OHCA and experienced restored spontaneous circulation after cardiopulmonary resuscitation. Among them, only five (4.1%) patients recovered consciousness to the level of CPC 1–2. The initial arterial pH and HCO3− were prognostic factors in hanging patients with OHCA.
Conclusions
Even though cardiac arrest did not occur after hanging injuries, 7.5% of patients could not recover consciousness. Therapeutic hypothermia should be considered for such patients. If OHCA occurred after the hanging injury, the proportion of patients with good neurologic outcome was very low at 4.1%.
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☆Notes: The authors have no financial conflicts of interest.
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