Outcome of patients with attempted suicidal hanging with pre-hospital cardiac arrest: A pilot observational ICU study
Background: Hanging with pre-hospital cardiac arrest is associated with increased hospital mortality and significant long-term neurological morbidity. Setting: Single centre, observational study at tertiary care ICU. Methods: All patients with suicidal hanging admitted to Westmead ICU from 1-Jan-201...
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Published in | International Journal of Critical Care Vol. 17; no. 3; pp. 6 - 21 |
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Main Authors | , |
Format | Journal Article |
Language | English |
Published |
01.12.2023
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Online Access | Get full text |
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Summary: | Background: Hanging with pre-hospital cardiac arrest is associated with increased hospital mortality and significant long-term neurological morbidity.
Setting: Single centre, observational study at tertiary care ICU.
Methods: All patients with suicidal hanging admitted to Westmead ICU from 1-Jan-2014 to 31-Dec-2019 were included in the study. Patient data obtained from ICU database and electronic health record was analysed for predictors of ICU outcome.
Results: Seventy-six patients with suicidal hanging presented to Westmead Emergency Department over a period of 6 years; of these, 47 (33 males, 14 females) were admitted to ICU. Mean age of patient cohort was 39.0 years (+13.6) and median APACHE-III score was 69.0. Twenty-seven patients (57.4%) were admitted following pre-hospital cardiac arrest due to a non-shockable rhythm (16 PEA, 11 asystole) as the first documented rhythm. Most (74.0%) of these patients had GCS of 3 at scene and this remained unchanged on arrival in the ED. This notwithstanding, 33.3% patients had a good neurological outcome. Among hanging patients without pre-hospital cardiac arrest, 95% had a good neurological outcome. This difference in outcome was significant. While several factors were associated with patient outcome on univariate analysis, only high APACHE-III score demonstrated a significant inverse relationship with good outcome on regression analysis. Presence of myoclonus at admission and pre-hospital cardiac arrest also had an inverse association with good outcome, but this was not statistically significant.
Conclusions: Outcome of hanging patients with pre-hospital cardiac arrest admitted to ICU was poor despite successful initial resuscitation as per international guidelines. High APACHE-III score was associated with poor outcome. |
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ISSN: | 2816-9050 2816-9050 |
DOI: | 10.29173/ijcc73 |