@article{ref1,
title="Outcomes in 886 Critically Ill Patients After Near-Hanging Injury",
journal="Chest",
year="2020",
author="de Charentenay, Louise and Schnell, Guillaume and Pichon, Nicolas and Schenck, Maleka and Cronier, Pierrick and Perbet, Sebastien and Lascarrou, Jean-Baptiste and Rossignol, Thomas and Lesieur, Olivier and Argaud, Laurent and Colin, Gwenhael and Cholley, Bernard and Quenot, Jean-Pierre and Merdji, Hamid and Silva, Stein and Piagnerelli, Michael and Chelly, Jonathan and Salvetti, Marie and Couraud, Segolene and Deye, Nicolas and Danguy Des Deserts, Marc and Paul, Marine and Thiery, Guillaume and Simon, Marc and Martin, Charlotte and Vincent, François and Das, Vincent and Jacq, Gwenaelle and Jacobs, Frédéric and Soummer, Alexis and Mayaux, Julien and Beuret, Pascal and Ouchenir, Abdelkader and Durant, Caroline and Darmon, Mickael and Azoulay, Elie and Sauneuf, Bertrand and Daubin, Cedric and Mongardon, Nicolas and Biard, Lucie and Cariou, Alain and Geeraerts, Thomas and Legriel, Stephane and Antigone Investigators, ",
volume="158",
number="6",
pages="2404-2413",
abstract="BACKGROUND: Near-hanging experiences are life-threatening events about which few data are available. RESEARCH QUESTION: What are the outcomes and early predictors of hospital mortality in critically ill patients who have undergone a near-hanging experience?STUDY DESIGN AND METHODS: Adult patients who were resuscitated successfully after suicidal near-hanging injury admitted to 31 university or university-affiliated ICUs in France and Belgium between 1992 and 2014 were studied retrospectively. Patients were identified by searching the hospital databases for International Statistical Classification of Diseases and Related Health Problems, 9th and 10th revisions, codes and hospital charts for hanging. Logistic multivariate regression was performed to identify factors associated vital and functional outcomes at hospital discharge as the primary end points. Secondary outcomes were evaluation of temporal trends and identification of predictors of hospital mortality. RESULTS: Of the 886 patients (181 women and 705 men; median age, 43 years; interquartile range, 34-52 years), 266 (30.0%) had attempted suicide previously, 600 (67.7%) had a diagnosed mental illness, and 55 (6.2%) attempted hanging while hospitalized. Median time from hanging awareness to unhanging was 0 min (interquartile range [IQR], 0-0; range, 0-82 min). Median Glasgow Coma Scale score was 3 (IQR, 3-5) at ICU admission. Hanging induced cardiac arrest in 450 of 886 patients (50.8%). Overall, 497 of 886 patients (56.1%) were alive at hospital discharge, including 479 of 497 patients (96.4%) with a favorable neurocognitive outcome (defined as a Glasgow Outcome Scale score of 4 or 5). By multivariate analysis, factors associated with hospital mortality were hanging-induced cardiac arrest (OR, 19.50; 95% CI, 7.21-60.90; P <.00001) and findings at ICU admission of glycemia level > 1.4 g/L (OR, 4.34; 95% CI, 1.82-10.81; P =.0007) and of lactate level > 3.5 mmol/L (OR, 9.98; 95% CI, 4.17-25.36; P <.00001). INTERPRETATION: The findings from this large multicenter retrospective cohort emphasize the very high mortality after hanging injury chiefly because of hanging-induced cardiac arrest. However, patients who survive near-hanging experiences achieve excellent neurocognitive recovery. Studies of early neuroprotective strategies for patients who have undergone near-hanging experiences are warranted. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT04096976; URL: www.clinicaltrials.gov.<p /><p>Language: en</p>",
language="en",
issn="0012-3692",
doi="10.1016/j.chest.2020.07.064",
url="http://dx.doi.org/10.1016/j.chest.2020.07.064"
}