TY  - JOUR
PY  - 2020//
TI  - Outcomes in 886 Critically Ill Patients After Near-Hanging Injury
JO  - Chest
A1  - de Charentenay, Louise
A1  - Schnell, Guillaume
A1  - Pichon, Nicolas
A1  - Schenck, Maleka
A1  - Cronier, Pierrick
A1  - Perbet, Sebastien
A1  - Lascarrou, Jean-Baptiste
A1  - Rossignol, Thomas
A1  - Lesieur, Olivier
A1  - Argaud, Laurent
A1  - Colin, Gwenhael
A1  - Cholley, Bernard
A1  - Quenot, Jean-Pierre
A1  - Merdji, Hamid
A1  - Silva, Stein
A1  - Piagnerelli, Michael
A1  - Chelly, Jonathan
A1  - Salvetti, Marie
A1  - Couraud, Segolene
A1  - Deye, Nicolas
A1  - Danguy Des Deserts, Marc
A1  - Paul, Marine
A1  - Thiery, Guillaume
A1  - Simon, Marc
A1  - Martin, Charlotte
A1  - Vincent, François
A1  - Das, Vincent
A1  - Jacq, Gwenaelle
A1  - Jacobs, Frédéric
A1  - Soummer, Alexis
A1  - Mayaux, Julien
A1  - Beuret, Pascal
A1  - Ouchenir, Abdelkader
A1  - Durant, Caroline
A1  - Darmon, Mickael
A1  - Azoulay, Elie
A1  - Sauneuf, Bertrand
A1  - Daubin, Cedric
A1  - Mongardon, Nicolas
A1  - Biard, Lucie
A1  - Cariou, Alain
A1  - Geeraerts, Thomas
A1  - Legriel, Stephane
A1  - Antigone Investigators, 
SP  - 2404
EP  - 2413
VL  - 158
IS  - 6
N2  - 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>
LA  - en
SN  - 0012-3692
UR  - http://dx.doi.org/10.1016/j.chest.2020.07.064
ID  - ref1
ER  -