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Neurologic outcome of comatose survivors after hanging: a retrospective multicenter study

Authors
 Min Joung Kim  ;  Yoo Sang Yoon  ;  Joon Min Park  ;  Junho Cho  ;  Hoon Lim  ;  Hyunggoo Kang  ;  Hyun Jin Kim  ;  Seung Whan Kim  ;  Kyeong Ryong Lee 
Citation
 AMERICAN JOURNAL OF EMERGENCY MEDICINE, Vol.34(8) : 1464-1472, 2016 
Journal Title
 AMERICAN JOURNAL OF EMERGENCY MEDICINE 
ISSN
 0735-6757 
Issue Date
2016
MeSH
Adult ; Asphyxia/complications* ; Asphyxia/therapy ; Cardiopulmonary Resuscitation ; Coma/complications* ; Coma/therapy ; Consciousness* ; Female ; Humans ; Male ; Nervous System Diseases/etiology* ; Nervous System Diseases/prevention & control ; Prognosis ; Retrospective Studies ; Suicide, Attempted* ; Survivors*
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%.
Full Text
http://www.sciencedirect.com/science/article/pii/S0735675716300602
DOI
10.1016/j.ajem.2016.04.036
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Min Joung(김민정) ORCID logo https://orcid.org/0000-0003-1634-5209
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Chung, Sung Pil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
Cho, Junho(조준호) ORCID logo https://orcid.org/0000-0003-2240-3989
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/152406
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