Pulmonary distress following attempted suicidal hanging.
OBJECTIVE
To assess the incidence of post-hanging pulmonary distress in cases of attempted suicidal hanging and predictors of outcome among these patients.


METHODS
Five-year retrospective analysis.


METHODS
Tertiary care center in south India.


METHODS
A total of 335 patients who attempted suicidal hanging, aged above 16 years, were admitted during this period. Thirty-eight of them with pulmonary distress established clinically and with radiological evidence of pulmonary injury post hanging met the inclusion criteria.


METHODS
Data from ICU records of 5 years, X-rays and laboratory investigations were reviewed. In patients identified to have post-hanging pulmonary distress, the neurological status, chest x-rays, arterial blood gas values and outcome data were collected and analyzed.


RESULTS
Eleven percent (n = 38) of the 335 patients admitted following attempted suicidal hanging were diagnosed to have post-hanging pulmonary distress. The overall mortality among post-hanging patients was 5%, which increased to 34.2% (n = 13) in the presence of pulmonary distress (P < or = 0.001). Among the prognostic factors evaluated, a PaO 2 / FiO 2 (P/F) ratio of < 100 at admission predicted a poor outcome (P < or = 0.001).


CONCLUSIONS
Post-hanging pulmonary distress is a relatively common complication of hanging and is associated with increased mortality. P/F ratio from arterial blood gas at admission was the only significant predictor of outcome in this group of patients.
Department of Neurological Sciences, Christian Medical College, Vellore, India.
Shalini
S
Nair
Joe
J
Jacob
Sanjith
S
Aaron
Maya
M
Thomas
Mathew
M
Joseph
Mathew
M
Alexander
D000328:Adult; D001237:Asphyxia / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India; D008297:Male; D019838:Neck Injuries / Q000150:complications*; D011379:Prognosis; D011654:Pulmonary Edema / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013405:Suicide; D013406:Suicide, Attempted