Near-Hanging – Early Predictors of Outcome

Written by Clay Smith

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Patients with near-hanging had 44% in-hospital mortality. Of those who survived, 96% had a good neurological outcome. Hanging-induced arrest, hyperglycemia, and hyperlactatemia were all associated with in-hospital mortality.

Why does this matter?
These patients are so sad to take care of. Yet, I have seen remarkable recovery in patients who initially looked terrible. After a near-hanging event, what is the prognosis? What are the early predictors of mortality? This can help us set appropriate expectations for loved ones.

Hanging – those who survive to discharge often do well
This was a multicenter study of 886 adult patients with self-inflicted near-hanging injury who were resuscitated and made it to the hospital. Half of them had cardiac arrest from hanging injury. In total, 56% survived to discharge. Of survivors, 96.4% had favorable neurological outcome. Factors associated with in-hospital mortality were hanging-induced cardiac arrest, glucose >142 mg/dL on ICU admission, and lactate >3.5 mmol/L on ICU admission. By far the strongest predictor of mortality was hanging-induced arrest.

Source
Outcomes in 886 Critically Ill Patients After Near-Hanging Injury. Chest. 2020 Dec;158(6):2404-2413. doi: 10.1016/j.chest.2020.07.064. Epub 2020 Aug 3.

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