Abstract

Introduction: Suicide is also the second most common cause of injury related death after road traffic injuries. Aim of the present study was to find out the influence of admission clinical variables on outcome of patients admitted to emergency room (ER) with attempted hanging. Material and Methods: A prospective observational study on patients presenting to emergency medicine department with history of attempted hanging and admitting under ICU/emergency medicine wards of SDM Medical college and Hospital, Dharwad. Study duration were about two years. Patients with >18 years of age with history of attempted hanging presenting to ED were included in our study Patients with GCS of 3/15 with bilateral dilated and non-reactive pupils and patients with history of attempted hanging and already diagnosed with hypoxic brain injury were excluded. Results: Out of 50, 27 were male and 23 were female with more cases in age group between 21-30 years. Time since incidence was one of the parameter influencing on duration of stay in hospital, which was more in 11 patients who presented after 6 hrs of incidence. 30 patients presented with GCS of less than 8 and all these were intubated. This is most significant parameter to predict duration of hospital stay. Majority of patients had hyperglycemia but that did not influence much on patients stay in hospital. 35 cases had GRBS more than 126mg/dl at the time of presentation. All patients underwent CT Brain with C-spine scan which revealed abnormality in 15 cases. These patients also had more number of hospital stay than compared with normal scan finding cases. Conclusion: In our study it has been evident that presenting clinical parameters including vital status of the victim, level of sensorium/ severity of brain Injury, non-modifiable factors such as age and initial CT scan findings will guide an emergency physician to explaining prognosis in a case of attempted hanging.

• 1.   Evans G, Norman L. Farberow. The Encyclopedia of Suicide.New York, NY: Facts on File,1988.
• 2.   Braun W. Sallekhana: The ethicality and legality of religious suicide by starvation in the Jain religious community. Med Law 2008;27:913-24.
• 3.   Bhugra D. Sati: A type of nonpsychiatric suicide. Crisis 2005;26:73-7.
• 4.   Vijayakumar L. Altruistic suicide in India. Arch Suicide Res 2004;8:73-80.
• 5.   Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012; 380: 2095-2128.
• 6.   Phillips MR, Cheng HG. The changing global face of suicide. Lancet. 2012; 379: 2318-2319.
• 7.   Hedge RS. Suicide in rural community. Indian J Psychiatry. 1980;22:368-70.
• 8.   Soman CR, Safraj S, Kutty VR, Vijayakumar K, Ajayan K. Suicide in South India: a communitybased study in Kerala. Indian journal of psychiatry. 2009 Oct;51(4):261.
• 9.   Sauvaget C, Ramadas K, Fayette JM, Thomas G, Thara S, Sankaranarayanan R. Completed suicide in adults of rural Kerala: rates and determinants. National Medical Journal of India. 2009 Sep 1;22(5):228.
• 10.   Costache VS, Renaud C, Brouchet L, Toma T, Le Balle F, Berjaud J, Dahan M. Complete tracheal rupture after a failed suicide attempt. The Annals of thoracic surgery. 2004 Apr 1;77(4):1422-3.
• 11.   Clark A, Das JM, Mesfin FB. Trauma neurological exam. InStatPearls [Internet] 2021 Jul 25. StatPearls Publishing.
• 12.   Matsuyama T, Okuchi K, Seki T, Murao Y. Prognostic factors in hanging injuries. Am J Emerg Med 2004;22:207-10.
• 13.   Ganesan R, Joseph RI, Subramanian K. Can clinical variables at admission influence the outcome in patients with suicidal hanging: a prospective study. Int J Adv Med 2016;3:959-64.
• 14.   Penney DJ, Stewart AH, Parr MJ. Prognostic outcome indicators following hanging injuries. Resuscitation 2002;54:27-9.
• 15.   Jawaid MT, Amalnath SD, Subramanyam D. Neurological outcomes following suicidal hanging: A Prospective study of 101 patients. Ann Indian AcadNeurol 2017;20:106-8.

Data Sharing Statement

Funding