Prognosis at 6 and 12 months after self-attempted hanging

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Abstract

Introduction:

Patients surviving a self-attempted hanging have a total neurological recovery in 57–77% of cases at hospital discharge, but no long-term data are available.

Methods:

In this observational study, all patients hospitalized post-self-attempted hanging in the intensive care unit (ICU) in a 5-year period were included. Neurological evaluations at 6 and 12 months were performed according to Cerebral Performance Category (CPC) scores. Factors associated with neurological recovery were determined by comparing CPC2 + 3 + 4 (bad recovery) vs. CPC1 (good recovery).

Results:

Of 231 patients included, 104 (47%) were found to have cardiac arrest (CA). Ninety-five (41%) patients died in the ICU: 93 (89%) in the CA group and 2 (1.6%) in the group without CA. Neurological evaluations at 6 and 12 months were obtained in 97 of the 136 surviving patients. At 6 months, in the CA group (n = 9), the CPC score was 1 for 6 patients, 2 for 2, and 4 for 1 patient. In the group without CA (n = 88), 79 patients had normal neurological status at 6 months and 78 at 12 months. Among these patients, 96% returned home, 77% returned to work, 16 (18%) patients re-attempted suicide within the year. Risk factors of neurological sequelae at 6 months were a CA at the hanging site (P = 0.045), an elevated diastolic blood pressure (87 vs. 70 mm Hg; P = 0.04), a lower initial Glasgow score (4 vs. 5; P = 0.04), and an elevated blood glucose level (139 vs. 113 mg/dL; P < 0.001).

Conclusion:

Patients surviving a self-attempted hanging who did not have a CA had a good neurological outcome. The rate of suicidal recidivism is particularly important, which justifies joint work with psychiatrists.

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