Demographic data and ICU findings analysis of hanging patients

Aim: The hanging, is usually one of the methods to commit suicide, is one of the most fatal suicide attempts. Due to sudden drop of the body, shake, and compression of the neck; cerebral injuries, injuries related to structure of the neck, vascular injuries, respiratory failure, and pulmonary complications can be seen. The hanging is a condition that requires intensive care treatment. In this study, the demographic, clinical, laboratory, and intensive care data of patients in intensive care units due to vaccine at our hospital between January 2006 and December 2012, were analyzed and studied their effects on mortality and survival retrospectively. Materials and Methods: The study is included in patients who were followed at the intensive care units of DÜTF between January 2006 and December 2012 due to hanging. The demographic data, physical examination findings at the time of the first application cases (Glasgow coma scale, light reflex, Babinski reflex, mean arterial blood pressure, respiratory rate, oxygen saturation), blood gases, complete blood count, biochemical parameters were recorded by help of the epicrysis files of 43 patients included in the study. Near hanging induced complications (cerebral edema, cerebral hemorrhage, laryngeal edema, cervical spine fracture / dislocation, pulmonary edema, pneumothorax) were recorded. Need of intubation, duration of intubation, intensive care unit, the brain protective therapy, pulmonary complications, pulmonary complications during follow-up of intensive care patients were analyzed, then the relationship of these findings with mortality and survival were analyzed. The study statistics was evaluated by the Chi-square, the Mann-Whitney U-test, Pearson correlation test. Results: In the study, 28 of 43 patients (65%) were male and 15 (35%) were female. The average age of the patients was 21.4 ± 6.8. Estimated mean duration of hanging were 25 ± 12min. GCS was evaluated as an average of 6 ± 2.9. 70% of patients were found with GCS ? 7. 38 of the 43 patients in intensive care units (88%) were intubated. The mean duration of intensive care unit stay was 8.3 ± 19 days respectively. In 12 patients(27.6%) with cranial imaging, brain edema or hemorrhage was seen. In 6 patients (14%) cervical spine fracture / dislocation was detected. Due to development of cardiac arrest prior to the intensive care unit at 7 patients (16.3%), cardiopulmonary resuscitation was applied. Complications of the neck; larynx injury was seen at 8 (18.5%) patients, and tracheal injury was seen at 3 (7%) patients. Pneumothorax was observed in 3 patients. In 26 (60%) patients, laryngeal edema was found. A significant relationship was found between mortality and low-level GCS value of the patients, duration of hanging, the light reflex, Babinski reflex, the average blood pressure value, the level of saturation, and respiration rate. At blood gas which is one of the laboratory values of patients, pH, HCO3, and SO2 was significantly correlated with mortality. A significant relationship was found between mortality and biochemical parameters such as urea, creatinine, AST, ALT, K, Ca values. Also, a significant relationship was found between mortality and presence of intubation, duration of intubation, duration of intensive care, brain edema / hemorrhage, pulmonary complications, electrolyte disorder of patients in the intense care unit. Conclusion: The hanging is a table with high mortality rates, and hanging duration, GCS, acidosis, cerebral complications are prognostic factors for mortality. It is thought that mortality can be reduced by early detection of cases of vaccine, relief of respiratory tract, correction of acidosis, accurate fluid-electrolyte therapy.