Prognostic Factors of Hospital Mortality After Near Hanging: A Retrospective two-Center French Study

J Intensive Care Med. 2024 Dec 4:8850666241303881. doi: 10.1177/08850666241303881. Online ahead of print.

Abstract

Introduction: suicide is a global public health issue, with over 800 000 people taking their own lives every year. However, most suicide attempts do not result in death. Hanging is the most common method used in France, often leading to post-hanging coma (PHC). The prognosis for patients admitted in intensive care unit (ICU) following PHC is poor, yet predictive criteria of mortality have been poorly evaluated.

Methods: we retrospectively collected prehospital and in-hospital data from 65 patients hospitalized in 2 French ICU for PHC, between first March 2010 and first August 2023, and compared characteristics between patients alive and dead.

Results: hospital mortality was 52%. Among baseline characteristics, SAPSII and pre-hospital cardiac arrest were associated with mortality, respectively 47 versus 62 (P = .005) and 32% versus 85% (P = .001). Concerning neuroprognostication, abnormal pupillary light reflex (PLR) was more frequent in patients who died (14% vs 56%, P = .002), as abnormal EEG (0% vs 32%, P = .002) and abnormal transcranial doppler (10% vs 35%, P = .031).

Conclusion: we identified several poor prognostic factors associated with hospital mortality after PHC. Further larger-scale studies are needed to supplement these findings.

Keywords: coma; near hanging; neuropronostication; suicide.