J Korean Soc Emerg Med.  2015 Oct;26(5):400-408. 10.0000/jksem.2015.26.5.400.

The Characteristics of Patients with Hanging Injury and the Usefulness of S100B Protein as a Predictive Factor According to the Presence of Cardiac Arrest

Affiliations
  • 1Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Republic of Korea. amita62@nate.com

Abstract

PURPOSE
Brain injury due to hanging leads has a high mortality rate and severe neurological sequelae. Serum S100B for predicting brain injury in hanging injury has not been evaluated. The aim of this study is to review the characteristics and the prognosis of hanging patients and to determine the usefulness of S100B as a predicting factor.
METHODS
A single center, retrospective study was conducted from January 2011 to December 2014. A total of 102 patients visited the emergency department (ED) with hanging injuries and 70 resuscitated patients were enrolled.
RESULTS
Of all patients, 56 (54.9%) patients were male and 96 (94.1%) patients committed suicide by hanging; 61 (59.8%) patients visited the ED with cardiac arrest. In arrest patients, all survived patients showed a Cerebral Performance Category (CPC) score of 4. Although 16 (39.0%) had the initial mental status as stupor or coma in non-arrest patients, 1 (2.4%) remained as CPC 4. Among the resuscitated patients, comatose mental status, absence of pupil light reflex (PLR), and diffuse swelling on brain computed tomography (CT) tended to show relation to high mortality rate. Only PLR tended to show relation to CPC score in non-arrest patients. The elevated level of serum S100B was related to the mortality in arrest patients, whereas it was not related to CPC score in non-arrest patients.
CONCLUSION
The prognosis of hanging patients was related to PLR irrespective of the presence of cardiac arrest. The serum S100B level for prediction of prognosis is not sufficient in non-arrest patients with hanging.

Keyword

Asphyxia; Neck injuries; S100B protein; Human; Heart arrest

MeSH Terms

Asphyxia
Brain
Brain Injuries
Coma
Emergency Service, Hospital
Heart Arrest*
Humans
Male
Mortality
Neck Injuries
Prognosis
Pupil
Reflex
Retrospective Studies
Staphylococcal Protein A*
Status Epilepticus
Stupor
Suicide
Staphylococcal Protein A
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