DOI: http://dx.doi.org/10.18203/2349-3933.ijam20163731

Can clinical variables at admission influence the outcome in patients with suicidal hanging: a prospective study

Joseph Raajesh I., Kumaran Subramanian

Abstract


Background: Hanging is considered one of the commonest ways of committing suicide, next only to poisoning in India. Very little information is only available in medical literature about prognosticating factors in suicidal hanging. Analysis of various parameters at the time of admission and their association with outcome can help in risk stratification as well as prognostication.

Methods: Four variables namely GCS, Mean arterial pressure, Oxygen saturation and capillary blood sugar were recorded at the time of admission. All patients received standard intensive care throughout the stay in ICU as demanded. Outcome was divided in to two groups, Good and poor. Good outcome was defined as complete neurological recovery at the time of discharge and poor outcome was defined as either death during hospital stay or persistent neurological deficit which did not improve even after a period of three months follow up.

Results: Total of forty patients was included in the study. Male patients outnumbered the number of female patients admitted with suicidal hanging. Irrespective of the gender more patients belonged to the third decade of. Out of forty, thirty patients showed complete neurological recovery, five patients had persistent neurological deficit even after three months and five patients died during the course of the treatment.

Conclusions: The present study confirms the age and sex distribution of suicidal hanging which is more common amongst male gender and 3rd followed by 4th decade of life in both sex. Admission parameters like GCS≤8, MAP < 60 mmHg and CBG >180mg % can be considered as risk factors for poor outcome.


Keywords


Outcome, Risk factors, Suicidal hanging

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References


Beautrais AL. Methods of youth suicide in New Zealand: trends and implications for prevention. Aust N Z J Psychiatry. 2000;34(3):413-9.

Wilkinson D, Gunnell D. Comparison of trends in method-specific suicide rates in Australia and England and amp; Wales, 1968-97. Aust N Z J Public Health. 2000;24(2):153-7.

Gunnell D. The epidemiology and prevention of suicide by hanging: a systematic review. Int J Epidemiol. 2005;34(2):433-42.

Vijayakumari N. Suicidal Hanging : A Prospective Study: J Indian Acad Forensic Med. 2011;33(4):971-3.

McHugh TP SM. Near-hanging injury. Ann Emerg Med. 1983;12(12):774-6.

Adams N. Near hanging. Emerg Med Australas. Blackwell Science Asia Pty. Ltd. 1999;11(1):17-21.

Gandhi R, Taneja N, Mazumder P. Near hanging: Early intervention can save lives. Indian J Anaesth. Medknow Publications. 2011;55(4):388-91.

Nokes LD, Roberts A, James DS. Biomechanics of judicial hanging: a case report. Med Sci Law. 1999;39(1):61-4.

Salim A, Martin M, Sangthong B, Brown C, Rhee P, Demetriades D. Near-hanging injuries: A 10-year experience. Injury. 2006;37(5):435-9.

Krol L Vande, Wolfe R. The emergency department management of near-hanging victims. J Emerg Med. 1994;12(3):285-92.

Penney DJ, Stewart AHL, Parr MJA. Prognostic outcome indicators following hanging injuries. Resuscitation. 2002;54(1):27-9.

Matsuyama T, Okuchi K, Seki T, Murao Y. Prognostic factors in hanging injuries. Am J Emerg Med. 2004;22(3):207-10.

Karanth S, Nayyar V. What influences outcome of patients with suicidal hanging. J Assoc Physicians India. 2005;53:853-6.

Khajavikhan J, Vasigh A, Kokhazade T, Khani A. Association between Hyperglycaemia with Neurological Outcomes Following Severe Head Trauma. J Clin Diagn Res. 2016;10(4):PC11-3.