Early Factors Affecting Prognosis of Patients with Hanging Injury

Jeong, Jin Hee; Lee, Kyung Woo; Kang, Tae Shin; Jung, Sang Min; Lee, Sang Bong; Kim, Dong Hoon; Kim, Sung Choon; Park, In Sung; Kang, Chang Woo

Abstract

PURPOSE
Hanging is a common method of suicide around the world. The prognosis after hanging injury is highly variable. Some patients die despite intensive treatment, while other patients recover without neurologic sequelae. The purpose of this study was to identify several prognostic factors affecting the outcome in patients with hanging injury.
METHODS
Thirty-five patients presented at Gyeongsang National University Hospital between May 2005 and July 2009 following hanging injury. Patients, of whom 30 were unconscious, were classified as being in the initial mental status. For these patients, we investigated several factors and identified correlations between factors and prognosis. We investigated the type of hanging, mental status, presence of pupillary light reflex, glasgow coma scale (GCS), laboratory findings, presence of cardiopulmonary resuscitation (CPR) and intubation, history of psychiatric disease, alcohol use, hanging duration, brain computed tomography (CT), and injury of the spine and neck soft tissue.
RESULTS
Factors suggesting a poor prognosis factors were complete hanging, poor mental status, the absence of pupillary light reflex, initial GCS, pH, bicarbonate and excess level of base, the practice of CPR and intubation. In particular, patients who showed GCS scores lower than 4.5 in the emergency room were highly likely to die.
CONCLUSION
Patients after hanging injury can recover without neurologic sequelae despite altered mental status. The prognosis of patients who present with hanging injury can be established by the type of hanging, initial mental status, the presence of pupillary light reflex, initial GCS, arterial blood gas analysis (ABGA), and the practice of CPR and intubation. Therefore patients with hanging injury should be treated aggressively with consideration of prognostic factors.