Near-hanging injuries: A 10-year experience

Objective: To review the injury patterns and analyse outcomes in patients who present after near-hanging. Methods: This is a trauma registry study that included all patients who were admitted to an academic Level I trauma centre with the diagnosis of attempted suicide by hanging between January 1993 and December 2003. All patients who were dead on arrival or in cardiopulmonary arrest were excluded. Data regarding demographics, injuries, and outcomes were examined. Independent risk factors for poor outcome were identified. Results: During the 10-year study period, 63 patients were admitted after near-hanging. A total of 12 patients (19%) had 17 injuries. Cervical spine fractures occurred in nearly 5% of cases. Four factors were found to be significantly associated with poor outcome: systolic blood pressure <90, Glasgow coma score ≤8, anoxic brain injury on computed tomography (CT) scan, and injury severity score >15. However, logistic regression analysis found only anoxia on CT scan to be independently associated with poor outcome (p < 0.01). Conclusion: Injuries commonly occurred after near-hanging. Liberal screening using CT scans is warranted. The prognosis is favorable, even with patients who arrive with a GCS ≤8. Overall survival was 90% and only 3.5% were discharged with severe or permanent disability.