Min Joung Kim1, Yoo Sang Yoon2, Joon Min Park3, Junho Cho1, Hoon Lim4, Hyunggoo Kang5, Hyun Jin Kim6, Seung Whan Kim7, Kyeong Ryong Lee8, Gun Bea Kim9, Jung Soo Park10, Hye Sun Lee11, Sung Phil Chung12. 1. Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea. 2. Department of Emergency Medicine, Inje University Busan Paik Hospital, Busan, Korea. 3. Department of Emergency Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea. 4. Department of Emergency Medicine, Bucheon Hospital of Soonchunhyang University, Bucheon, Korea. 5. Department of Emergency Medicine, Hanyang University College of Medicine, Seoul, Korea. 6. Department of Emergency Medicine, Konyang University College of Medicine, Daejeon, Korea. 7. Department of Emergency Medicine, College of Medicine, Chungnam National University, Daejeon, Korea. 8. Department of Emergency Medicine, Konkuk University School of Medicine, Seoul, Korea. 9. Department of Emergency Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea. 10. Department of Emergency Medicine, Chungbuk National University Hospital, Cheongju, Korea. 11. Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea. 12. Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea. Electronic address: emstar@yuhs.ac.
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%.
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 hangingpatients 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 comatosepatients 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%.
Authors: Carsten Lott; Anatolij Truhlář; Anette Alfonzo; Alessandro Barelli; Violeta González-Salvado; Jochen Hinkelbein; Jerry P Nolan; Peter Paal; Gavin D Perkins; Karl-Christian Thies; Joyce Yeung; David A Zideman; Jasmeet Soar Journal: Notf Rett Med Date: 2021-06-10 Impact factor: 0.826