Insights into pathophysiology, management, and outcomes of near‑hanging patients: A narrative review

Abstract

Hanging is suspension of a person by noose or ligature around the neck. Hanging has been used as a judicial execution method since medieval times and is still a common method of suicide in developing countries. The term “near hanging” is used for those who survive long enough to reach the hospital, and these patients still hold mortality as high as 45%. These patients can present with a wide array of complaints involving cardiovascular, neurologic, and pulmonary systems and local injuries to the airway and vascular structures. High serum lactate and cardiac arrest at arrival are some of the prognostic factors which portend a poor prognosis. Early admission and aggressive treatment are essential to provide best neurologic outcome. Due to paucity of definitive guidelines, therapy has to be based on clinical reports and expertise of the treating physician. Hence, near‑hanging patients pose a great challenge in primary emergency care and intensive care management. This review aims to outline the pathophysiology, prognostic indicators, and recent evidence in the management of near‑hanging patients.