The Analysis of Pathophysiolosy and Outcome of Hanging

Abstract

Hanging has been known as a significant method of suicide due to its high completion rate. The purpose of this study was to analyze the factors that influence the outcome of hanging, by comparing the actual clinical course with the pathophysiology of hanging derived from laboratory experiments. (Patients and methods) Of 411 with suicide attempt during the period from April 1998 through August 2003, 44 hangings were examined. With respect to the completion rate of suicide, we compared hanging with other methods. We divided the hangings into 2 groups by presentation of cardiopulmonary arrest (CPA) upon arrival of emergency medical technician (EMT), and compared the clinical course and the outcome of these 2 groups. Moreover, we divided the non-CPA group into 2 subgroups in accordance with severity of consciousness impairment on admission, and compared average age, gender, the type of hanging, mortality rate, rehabilitation rate, and the incidence of delayed postanoxic encephalopathy. Finally to analyze prognostic factors in hanging, all 44 patients were examined for factors such as age, gender, the type of hanging, and the presence of CPA. (Results) Hanging patients accounted for 10.7% of the patients with suicide attempt, and the completion rate of hanging was the highest (75%) in others. Of these hangings, CPA upon arrival of ELST accounted for 33. Of these hangings of CPA, 7 were resuscitated. However, 6 resulted in death and only 1 could be rehabilitated. On the other hand, of 11 hangings of non-CPA, 1 died and the other 10 could be all rehabilitated. In 2 subgroups of these 11, we revealed no significant differences in background, clinical course and outcome. In a prognostic study of the 44 hangings, only the presence of CPA showed significant differences between survivors and non-survivors..