The Effective Factors on Survival in Near-Hanging

Abstract

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...