Frontiers in Neurology (Sep 2023)

Epidemiology and outcome predictors in 450 patients with hanging-induced cardiac arrest: a retrospective study

  • Marie Salvetti,
  • Guillaume Schnell,
  • Nicolas Pichon,
  • Nicolas Pichon,
  • Maleka Schenck,
  • Pierrick Cronier,
  • Pierrick Cronier,
  • Sebastien Perbet,
  • Jean-Baptiste Lascarrou,
  • Jean-Baptiste Lascarrou,
  • Christophe Guitton,
  • Olivier Lesieur,
  • Olivier Lesieur,
  • Laurent Argaud,
  • Laurent Argaud,
  • Gwenhael Colin,
  • Gwenhael Colin,
  • Bernard Cholley,
  • Jean-Pierre Quenot,
  • Hamid Merdji,
  • Hamid Merdji,
  • Thomas Geeraerts,
  • Michael Piagnerelli,
  • Gwenaelle Jacq,
  • Marine Paul,
  • Jonathan Chelly,
  • Jonathan Chelly,
  • Louise de Charentenay,
  • Nicolas Deye,
  • Nicolas Deye,
  • Nicolas Deye,
  • Marc Danguy des Déserts,
  • Guillaume Thiery,
  • Marc Simon,
  • Vincent Das,
  • Frederic Jacobs,
  • Charles Cerf,
  • Julien Mayaux,
  • Pascal Beuret,
  • Abdelkader Ouchenir,
  • Antoine Lafarge,
  • Bertrand Sauneuf,
  • Bertrand Sauneuf,
  • Cedric Daubin,
  • Cedric Daubin,
  • Alain Cariou,
  • Alain Cariou,
  • Alain Cariou,
  • Stein Silva,
  • Stein Silva,
  • Stephane Legriel,
  • Stephane Legriel,
  • Stephane Legriel

DOI
https://doi.org/10.3389/fneur.2023.1240383
Journal volume & issue
Vol. 14

Abstract

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BackgroundCardiac arrest is the most life-threatening complication of attempted suicide by hanging. However, data are scarce on its characteristics and outcome predictors.MethodsThis retrospective observational multicentre study in 31 hospitals included consecutive adults admitted after cardiac arrest induced by suicidal hanging. Factors associated with in-hospital mortality were identified by multivariate logistic regression with multiple imputations for missing data and adjusted to the temporal trends over the study period.ResultsOf 450 patients (350 men, median age, 43 [34–52] years), 305 (68%) had a psychiatric history, and 31 (6.9%) attempted hanging while hospitalized. The median time from unhanging to cardiopulmonary resuscitation was 0 [0–5] min, and the median time to return of spontaneous circulation (ROSC) was 20 [10–30] min. Seventy-nine (18%) patients survived to hospital discharge. Three variables were independently associated with higher in-hospital mortality: time from collapse or unhanging to ROSC>20 min (odds ratio [OR], 4.71; 95% confidence intervals [95%CIs], 2.02–10.96; p = 0.0004); glycaemia >1.4 g/L at admission (OR, 6.38; 95%CI, 2.60–15.66; p < 0.0001); and lactate >3.5 mmol/L at admission (OR, 6.08; 95%CI, 1.71–21.06; p = 0.005). A Glasgow Coma Scale (GCS) score of >5 at admission was associated with lower in-hospital mortality (OR, 0.009; 95%CI, 0.02–0.37; p = 0.0009).ConclusionIn patients with hanging-induced cardiac arrest, time from collapse or unhanging to return of spontaneous circulation, glycaemia, arterial lactate, and coma depth at admission were independently associated with survival to hospital discharge. Knowledge of these risk factors may help guide treatment decisions in these patients at high risk of hospital mortality.

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